Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands.
J Orthop Traumatol. 2023 Aug 11;24(1):42. doi: 10.1186/s10195-023-00724-4.
Carbon-fibre (CF) plates are increasingly used for fracture fixation. This systematic review evaluated complications associated with CF plate fixation. It also compared outcomes of patients treated with CF plates versus metal plates, aiming to determine if CF plates offered comparable results. The study hypothesized that CF plates display similar complication rates and clinical outcomes as metal plates for fracture fixation.
The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched from database inception until June 2023: PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare, Academic Search Premier and Google Scholar. Studies reporting on clinical and radiological outcomes of patients treated with CF plates for traumatic fractures and (impending) pathological fractures were included. Study quality was assessed, and complications were documented as number and percentage per anatomic region.
A total of 27 studies of moderate to very low quality of evidence were included. Of these, 22 studies (800 patients, median follow-up 12 months) focused on traumatic fractures, and 5 studies (102 patients, median follow-up 12 months) on (impending) pathological fractures. A total of 11 studies (497 patients, median follow-up 16 months) compared CF plates with metal plates. Regarding traumatic fractures, the following complications were mostly reported: soft tissue complications (52 out of 391; 13%) for the humerus, structural complications (6 out of 291; 2%) for the distal radius, nonunion and structural complication (1 out of 34; 3%) for the femur, and infection (4 out of 104; 4%) for the ankle. For (impending) pathological fractures, the most frequently reported complications were infections (2 out of 14; 14%) for the humerus and structural complication (6 out of 86; 7%) for the femur/tibia. Comparative studies reported mixed results, although the majority (7 out of 11; 64%) reported no significant differences in clinical or radiological outcomes between patients treated with CF or metal plates.
This systematic review did not reveal a concerning number of complications related to CF plate fixation. Comparative studies showed no significant differences between CF plates and metal plates for traumatic fracture fixation. Therefore, CF plates appear to be a viable alternative to metal plates. However, high-quality randomized controlled trials (RCTs) with long-term follow-up are strongly recommended to provide additional evidence supporting the use of CF plates.
III, systematic review.
碳纤维（CF）板越来越多地用于骨折固定。本系统评价评估了与 CF 板固定相关的并发症。它还比较了使用 CF 板和金属板治疗的患者的结果，旨在确定 CF 板是否提供了可比的结果。该研究假设 CF 板在骨折固定方面显示出与金属板相似的并发症发生率和临床结果。
该研究遵循系统评价和荟萃分析的首选报告项目指南。从数据库成立到 2023 年 6 月，检索了以下数据库：PubMed、MEDLINE、Embase、Web of Science、Cochrane 图书馆、Emcare、学术搜索高级版和 Google Scholar。纳入了报告使用 CF 板治疗创伤性骨折和（即将发生）病理性骨折患者的临床和影像学结果的研究。评估了研究质量，并按解剖区域记录并发症的数量和百分比。
共纳入 27 项研究，质量为中等到极低。其中，22 项研究（800 名患者，中位随访 12 个月）关注创伤性骨折，5 项研究（102 名患者，中位随访 12 个月）关注（即将发生）病理性骨折。共有 11 项研究（497 名患者，中位随访 16 个月）比较了 CF 板和金属板。关于创伤性骨折，主要报告了以下并发症：肱骨的软组织并发症（391 例中有 52 例，13%）、桡骨远端的结构并发症（291 例中有 6 例，2%）、股骨的骨不连和结构并发症（34 例中有 1 例，3%）以及踝关节感染（104 例中有 4 例，4%）。对于（即将发生）病理性骨折，最常报告的并发症是肱骨感染（14%，14 例中有 2 例）和股骨/胫骨结构并发症（7%，86 例中有 6 例）。比较研究报告了混合结果，尽管大多数（11 项中的 7 项，64%）报告 CF 或金属板治疗的患者在临床或影像学结果方面没有显著差异。
本系统评价并未发现与 CF 板固定相关的大量并发症。比较研究表明，CF 板与金属板在治疗创伤性骨折方面没有显著差异。因此，CF 板似乎是金属板的一种可行替代品。然而，强烈建议进行高质量的随机对照试验（RCT）并进行长期随访，以提供支持 CF 板使用的额外证据。
III，系统评价。
