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Zhou M.,Anhui Medical University | Zhou M.,PLA Institute ofOrthopedic and Traumatology | Sun T.-s.,Anhui Medical University | Sun T.-s.,PLA Institute ofOrthopedic and Traumatology | And 6 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2012

BACKGROUND: Mason type III radial head fracture is the comminuted fracture of the radial head, the treatment is more difficult. Prosthetic replacement versus open reduction and internal fixation are the two main modalities, but there is a certain controversy on the efficacy of these two treatment modalities. OBJECTIVE: To verify the effectiveness of prosthetic replacement versus open reduction and internal fixation for the treatment of Mason type III radial head fracture through a Meta analysis which provides evidence for the clinical treatment of Mason type III radial head fracture. METHODS: We searched CENTRAL (The Cochrane Library, 1993-2011), Medline (1980-2011), Biomed Central (1997-2011), Ovid (1993-2011), China Academic Journal (CNKI, 1994-2011) and Wanfang database (1993-2011). The reports on the treatment of Mason type III radial head fracture by prosthetic replacement and open reduction and internal fixation were collected and the effect of these two modalities was compared through Meta analysis. RevMan 5.0 statistical software was used to perform the heterogeneity analysis and Meta analysis. RESULTS AND CONCLUSION: There were 3 controlled clinical trails and 1 randomized controlled trial, a total of 109 cases, of which 55 patients in prosthetic replacement group and 54 patients in open reduction and internal fixation group. 1 Effectiveness: according to the Broberg and Morrey elbow score, prosthetic replacement group was superior to open reduction and internal fixation group in good rate, the difference was statistically significant (P= 0. 001). 2 Complications: the incidence of complications in the open reduction and internal fixation group was higher than that in the prosthetic replacement group, and the difference was statistically significant (P=0.001). By evaluating the efficacy and complications of prosthetic replacement versus open reduction and internal fixation for the treatment of Mason type III radial heads, prosthetic replacement is superior to open reduction and internal fixation, with satisfactory results. But there was no significant difference of the elbow activity. In view of the less literatures and the poor quality, it needs to design a more rigorous randomized controlled trial and more case number to confirm the final conclusion. Source

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