title: Percutaneous Reduction and Fixation with Kirschner Wires versus Open Reduction Internal Fixation for the Management of Calcaneal Fractures: A Meta-Analysis.
abstract: The aim of our meta-analysis was to compare outcomes for two surgical treatments of calcaneal fractures, percutaneous reduction and fixation with Kirschner wires (PRFK) and open reduction internal fixation (ORIF), with the intent of evaluating the quality of evidence to inform practice. Search of MEDLINE, Cochrane and CNKI databases to identify randomized controlled trials (RCTs) comparing PRKF and ORIF on the following outcomes: post-operative function, complications and quality of the reduction. Odd ratios (OR) and weighted mean differences were pooled using either a fixed-effects or random-effects model, depending on the heterogeneity of the trials included in the analysis. Eighteen RCTs provided the data from 1407 patients. PRFK was associated with a lower risk of surgical wound complications, and ORIF with better post-operative function, angle of Gissane, calcaneal height, and calcaneal width. There were no statistically significant differences between the techniques with regards to post-operative Böhler's angle. PRFK does not provide a substantive advantage over ORIF for the treatment of calcaneal fractures in adults. PRFK may, however, yield comparable functional outcomes to ORIF for closed Sanders type II calcaneal fractures but with less complication related to surgical wound healing.
authors.affiliation: Department of Orthopaedic Surgery, the 2nd Affiliated Hospital &Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Province, China.
authors.forename: Jianbin
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Orthopaedic Surgery, the 2nd Affiliated Hospital &Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Province, China.
authors.forename: Feiya
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedic Surgery, the 2nd Affiliated Hospital &Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, the 2nd Affiliated Hospital &Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Tan
mesh_terms: D015982:Bias; D001864:Bone Wires; D002111:Calcaneus / Q000473:pathology* / Q000601:surgery*; D002986:Clinical Trials as Topic; D016001:Confidence Intervals; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D016017:Odds Ratio; D017594:Publication Bias; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000209:etiology