Statistical Heterogeneity was assessed using the Chi square test with significance set at P < 0.10. For dichotomous variables, we used odds ratios. For the continuous variables, we computed the mean differences with 95% confidence intervals. Review Manager Software 5.3 was used for statistical analysis of the data. The objective of our analysis was to assess the operative time, postoperative complications including infection, avascular necrosis, and nonunion. Two authors independently extracted data from the list of the included studies, and a third reviewer was required to make a final determination in the event of any discrepancies. Exclusion criteria: (1) lateral condyle humeral fractures with other fractures, (2) pathological fractures, (3) case reports, cadaver or model studies, and biomechanical studies (4) duplicate publications or studies did not provide sufficient raw data. Inclusion criteria: (1) clinical trials that compared ORIF versus CRPP between 20 (2) children younger than 18 years with lateral condyle humeral fractures (3) original data included some of the following: operative time, infection, avascular necrosis, and nonunion. Study selectionĬhildren with radiographically confirmed lateral condyle humeral fractures who has received ORIF or CRPP were recruited. We also performed a search on Google Scholar to review the references of selected studies. References, reviews and meta-analyses were then scanned for additional articles. The search terms lateral condyle humeral fracture, open reduction and internal fixation, closed reduction and percutaneous pinning, and children were used individually and in combination. Search strategiesĮlectronic searches were performed between 20 using EMBASE, PubMed, and MEDLINE. This study was conducted in accordance with the guidelines of the revised assessment of multiple systematic reviews and the preferred reporting items of the systematic reviews and meta-analyses 2020 statement. We hypothesize that CRPP and ORIF have similar clinical outcomes for lateral condyle humeral fractures in children. This meta-analysis was designed to illustrate the clinical outcomes and safety of two different management options for Song stage 2–4 lateral condyle humeral fractures in children. It is therefore necessary to evaluate the efficacy and safety of two different management options for the treatment of Song stage 2–4 lateral condyle humeral fractures in children. Currently, there is no relevant meta-analysis comparing closed versus open reduction for lateral condyle humeral fractures in children. Until now, there has been no general agreement among orthopedic surgeons on the most appropriate treatment for lateral condyle fracture of the humerus. In the last decade, there has been renewed interest in alternative approaches, such as closed reduction and percutaneous pinning (CRPP) for Song stage 2–4 lateral condyle humeral fractures. Traditionally, open reduction and internal fixation (ORIF) was preferred in order to assure anatomic reduction of this physeal, intra-articular fracture. Because this, if not managed properly, they can cause a variety complications including elbow deformity. These fractures are peculiar in that they are intra-articular and are prone to displacement due to the attachment of the extensor muscles of the forearm to the lateral condyle. Lateral humeral condyle fracture is the second most common elbow fracture in the pediatric age group, after supracondylar fractures. More high-quality randomized controlled trials are needed to determine this conclusion. ConclusionsĬlosed reduction and percutaneous pinning, as well as open reduction and internal fixation of lateral condyle humeral fractures in children, resulted in similar structural stability and functional outcomes. There was no significant difference between the closed reduction and percutaneous pinning, and open reduction and internal fixation in terms of the clinical outcomes based on infection, avascular necrosis, and nonunion ( P > 0.05). ResultsĮight clinical studies with 742 patients were eventually included in the meta-analysis. After testing for publication bias and heterogeneity between studies, the data was aggregated for stochastic effect models when necessary. The primary endpoints were clinical outcomes based on infection, avascular necrosis, and nonunion. Data were retrieved for patients with two different management options for lateral condyle humeral fractures in children. In January 2023, a systematic computer-based search was conducted. The objective of this meta-analysis was to illustrate the clinical outcomes and safety of two different management options for Song stage 2–4 lateral condyle humeral fractures in children.
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