To analyze and compare the differences in curative effect between staged open reductionand internal fixation (staged ORIF) and external fixation with limited internal fixation (EFLIF) by systematic review. Literatures about the effectiveness analysis of staged ORIF and EFLIF, published from 2000 to 2014, were collected through database retrieval and manual search. The index words were “Pilon fracture, tibia fracture, staged ORIF, EFLIF, therapy”. The evaluation indicators were set as soft tissue infection rate, osteomyelitis incidence rate, bone nonunion, malunion incidence rate and arthrodesis incidence rate. RevMan5.2 software was adopted to make relevant analysis. Six studies were included after the full text analysis. The results indicated that the soft tissue infection rate in Staged ORIF group was significantly lower than that of EFLIF group (Z=2.82, P=0.005). And there were no differences between the two groups respectively in osteomyelitis incidence rate(Z=0.97, P=0.33), bone nonunion(Z=0.48, P=0.63) , malunion incidence rate(Z=1.86, P=0.06) and arthrodesis incidence rate(Z=1.46ÿP=0.14). The soft tissue infection rate was lower when the technique of staged open reduction and internal fixation was used. However, with respect to the overall curative effect, there was no obvious difference comparing with the method external fixation with limited internal fixation.
Staged ORIF, EFLIF, pilon fracture, systematic review
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