Distal Intra Articular Tibial Fracture Treated by Ilizarov with Ligamentotaxis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Mohamed Fayd ◽  
Mohamed Ahmad Al-Kersh ◽  
Elia Saad Fakhry Bishay
Keyword(s):  
Systematic Review ◽  
External Fixator ◽  
Observational Studies ◽  
Tibial Fracture ◽  
Articular Surface ◽  
Meta Analysis ◽  
Distal Tibia ◽  
Delayed Union ◽  
Ilizarov External Fixator ◽  
Major Infection

Abstract Background The thin soft tissue and muscles envelope that surrounds the distal tibia makes treatment of these fractures difficult. These fractures are often referred to as ―pilon‖ fractures or ―plafond‖ fractures‖. If the articular surface of the tibia is involved; in such cases an anatomic realignment of the involved articular fracture in conjunction with a stable fixation is crucial. Objectives The aim of this paper is to conduct a systematic review of literature about functional and radiological outcomes in patients with distal intra articular tibial fracture treated by external fixator with ligamentotaxis. Materials and Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. MOOSE is a reporting checklist for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists Results Over all, five studies reported the time to union. The overall effect estimates showed that the time to union after Ilizarov external fixator was 12.83 weeks. Three studies reported the rate of union. The overall effect estimates showed that the rate of union after Ilizarov external fixator was 88.4%. Over all, eight studies reported the good-excellent AOFS score. The overall effect estimates showed that the rate of good-excellent AOFS score after Ilizarov external fixator was 69.4%. Nine studies reported the rate of malunion. The overall effect estimates showed that the rate of malunion after Ilizarov external fixator was 10.2%. Over all, seven studies reported the rate of delayed union. The overall effect estimates showed that the rate of delayed union after Ilizarov external fixator was 6.3%. All studies reported the rate of pin infection. The overall effect estimates showed that the rate of pin infection after Ilizarov external fixator was 33.7%. Ten studies reported the rate of major infection. The overall effect estimates showed that the rate of major infection after Ilizarov external fixator was 3.4. Conclusion External fixation and ligamentotaxis by either ilizarov or any external fixator is a good and easy method for fixation of distal intraarticulat tibial fracture with few serious complications. due to easy to apply it, less rate of infection, no risk of bleeding since no opening the fracture site, good aligment of the joint, no streaping of the periosteomy that lead to later on good and rapid healing of the fracture.

scholarly journals Delayed Tibial Shaft Fracture Healing Associated with Smoking: A Systematic Review and Meta-Analysis of Observational Studies Conducted Worldwide

2021 ◽  
Vol 18 (19) ◽  
pp. 10228
Author(s):  
Akanksha Mahajan ◽  
Narinder Kumar ◽  
Bhawna Gupta
Keyword(s):  
Systematic Review ◽  
Fracture Healing ◽  
Observational Studies ◽  
Meta Analysis ◽  
Shaft Fracture ◽  
Delayed Union ◽  
Cochrane Library ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Non Union

Tibial fractures represent a great burden of disease globally, being the most common long-bone fracture; smoking is a known risk factor for delayed skeletal healing and post-fracture complications. This systematic review and meta-analysis aims to analyse the effect of smoking on healing of tibial shaft fractures. PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched from inception to March 2021, with no limitation on language, to find relevant research. All observational studies that assessed the association between cigarette smoking and tibial shaft fracture healing in adults (≥18 years) were included. The quality of studies was evaluated using the Newcastle Ottawa Quality Assessment Scale. A random effects model was used to conduct meta-analysis. Tobacco smoking was associated with an increased rate of non-union and delayed union as well as an increase in time to union in fractures of the tibial shaft. Among the 12 included studies, eight reported an increased rate of non-union, three reported delayed union, and five reported an increase in time to union. However, the results were statistically significant in only three studies for non-union, one for delayed union, and two studies for increased time to union. This review confirms the detrimental impact of smoking on tibial shaft fracture healing and highlights the importance of patient education regarding smoking cessation.

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Central Obesity ◽  
Assessment Tool ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Cross Sectional ◽  
Inflammatory Status ◽  
Obesity Indices

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.

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