Abstract
Background The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the efficacy and safety between bone transport (BT) and acute shortening technique (AST) in the treatment of infected tibial bone defects.Materials and Methods A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, Embase together with China National Knowledge Infrastructure (CNKI), and Wanfang database for articles published as of August 9, 2019. NOS (Newcastle-Ottawa scale) and Cochrane's risk of bias tool were adapted to evaluated the bias and risk of each eligible study. The data of external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan V.5.3 was used to perform relevant statistical analyses. Relative risk (RR) were used for the binary variables and standard mean difference (SMD) for continuous variable. Each variable included its 95% confidence interval (CI).Results 5 studies, including a total of 199 patients, were included in the meta-analysis. Statistical significance was observed in EFI (SMD = 0.63,95% CI:0.25,1.01,P=0.001) and Bone grafting (RR = 0.26,95%CI:0.15,0.46,P<0.00001), however, no significance was observed in bone union time (SMD = -0.02, 95% CI: -0.39, 0.35, P=0.92), bone results (RR = 0.97,95%CI:0.91,1.04,P=0.41),functional results (RR = 0.96,95%CI:0.86,1.08,P=0.50) and complication (RR = 0.76,95%CI:0.41,1.39,P=0.37).Conclusions AST is preferred on the aspect of minimizing treatment period, while BT is superior to AST for reducing bone grafting. Due to the limited number of trials, The meaning of this conclusion should be taken with caution for infected tibial bone defects.
Bone transport versus acute shortening for the management of infected tibial bone defects: A meta-analysis
