Department of Orthopaedics and Traumatology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
TraumaEvidence @ German Society of Traumatology, Berlin, Germany.
Syst Rev. 2022 Sep 11;11(1):199. doi: 10.1186/s13643-022-02049-5.
The Calcaneus is the largest bone of the foot and the most frequent tarsal bone to be fractured. Overall, it causes round about 10 cases per 100,000 residents per year mainly in men. Especially displaced intra-articular calcaneus fractures often have early and late complications and its associated disability. There are various strategies for the treatment of displaced intra-articular calcaneus fractures, but the gold standard is still subject of a long-standing controversy. Minimally invasive procedures became more common in an attempt to reduce the high rate of complications associated with open reduction and internal fixation. With the increase in minimally invasive techniques, screw fixation also gained in significance. The current literature does not sufficiently elucidate whether the screw fixation is superior to other treatment options especially in relation to adverse events, health-related quality of life and postoperative pain. This study aims to investigate benefits and harms of treating displaced intra-articular calcaneus fractures (types II, III and IV according to Sanders) with screw fixation in adults.
A systematic review will be conducted based on the principles described in the Cochrane Handbook. We will include adults with displaced intra-articular calcaneus fractures of Sanders type II, III and IV. The surgical method of screw fixation shall be compared to other surgical interventions to stabilise calcaneus fractures. Primary outcomes are serious adverse events, health-related quality of life and postoperative pain level. MEDLINE, CENTRAL, CINAHL, Web of Science and bibnet.org, ClinicalTrial.gov and the World Health Organization International Clinical Trials Registry Platform (ICTR) will be searched. Screening and data extraction will be performed by two authors independently. A third author will arbitrate disputes. Risk of Bias will be assessed with the Cochrane tool. Meta-analysis will be performed if participants, interventions, comparisons and outcomes are sufficiently similar to ensure a result that is clinically meaningful.
Due to the increasing use of minimally invasive techniques and the increasing use of screw fixation instead of open reduction and plate fixation, it is important to analyse the benefits and harms of screw fixation for calcaneus fractures. Screw fixation could, in the future, help to operate in a less invasive and tissue preserving manner while still achieving an adequate functional result for the patient SYSTEMATIC REVIEW REGISTRATION: CRD42021244695.
跟骨是足部最大的骨头，也是最常发生骨折的跗骨。总体而言，它每年导致大约每 10 万居民中有 10 例骨折，主要发生在男性中。特别是移位的关节内跟骨骨折常有早期和晚期并发症及其相关残疾。对于移位的关节内跟骨骨折，有各种治疗策略，但金标准仍然存在长期争议。为了降低与切开复位内固定相关的高并发症发生率，微创方法变得越来越普遍。随着微创技术的增加，螺钉固定也变得越来越重要。目前的文献并没有充分阐明螺钉固定是否优于其他治疗选择，特别是在不良事件、健康相关生活质量和术后疼痛方面。本研究旨在调查成人用螺钉固定治疗移位的关节内跟骨骨折（根据 Sanders 分类为 II 型、III 型和 IV 型）的益处和危害。
将根据 Cochrane 手册中的原则进行系统综述。我们将纳入 Sanders 类型 II、III 和 IV 型移位的关节内跟骨骨折的成年人。螺钉固定的手术方法将与其他稳定跟骨骨折的手术干预进行比较。主要结局是严重不良事件、健康相关生活质量和术后疼痛程度。将检索 MEDLINE、CENTRAL、CINAHL、Web of Science 和 bibnet.org、ClinicalTrials.gov 和世界卫生组织国际临床试验注册平台（ICTR）。两名作者将独立进行筛选和数据提取。如有争议，将由第三名作者仲裁。将使用 Cochrane 工具评估偏倚风险。如果参与者、干预措施、比较和结局足够相似，以确保具有临床意义的结果，则将进行荟萃分析。
由于微创技术的使用增加以及螺钉固定而不是切开复位和钢板固定的使用增加，分析螺钉固定治疗跟骨骨折的益处和危害非常重要。螺钉固定将来可以帮助以微创和保留组织的方式进行手术，同时仍能为患者获得足够的功能结果。
CRD42021244695。
