Box McKenna W, Marsh Laurel, Major Josh, Puga Troy B, Poffenbarger Mason C, Riehl John T
Department of Orthopaedic Surgery, Medical City Denton, Denton, TX.
University of Oklahoma-Tulsa School of Community Medicine, Tulsa, OK.
OTA Int. 2025 May 8;8(2):e403. doi: 10.1097/OI9.0000000000000403. eCollection 2025 Jun.
To systematically review the literature on all reports of magnetic resonance imaging (MRI) use in patients with external fixators and evaluate for adverse events.
MEDLINE, Embase, and Cochrane were searched for English-language articles from January 1, 1995, to July 14, 2024.
Studies that described MRI use in a patient with an external fixator and measured whether adverse events occurred while the patient underwent MRI were included for analysis.
Two reviewers independently reviewed, selected included studies, and extracted data. A third reviewer resolved any discrepancies.
Six studies (Level IV evidence) were identified, including 358 MRI instances. The quality of the studies was evaluated using the Institute of Health Economics checklist for the quality appraisal of case series studies. No descriptive statistics were performed.
Overall, we found no reports (0.0%) of serious patient harm, including burns and changes in the stability of the external fixation. Four (1.1%) reports of patients feeling discomfort or pain led to early termination of the MRI with no long-term sequelae.
Overall, no patient harm events were reported in our systematic review of the available literature. Further studies are recommended to help develop future guidelines on using MRI in patients with external fixation. Currently, there is no known clinical evidence to suggest that MRI is not safe in the setting of a patient with an extremity external fixator; however, this topic remains controversial. The benefits of using MRI likely outweigh potential minor risks in this patient population, and the authors recommend against blanket restrictions prohibiting the use of MRI in patients with external fixation.
Therapeutic Level IV.
系统回顾关于外固定器患者使用磁共振成像（MRI）的所有报告文献，并评估不良事件。
检索MEDLINE、Embase和Cochrane数据库，查找1995年1月1日至2024年7月14日期间的英文文章。
纳入描述外固定器患者使用MRI并测量患者在接受MRI时是否发生不良事件的研究进行分析。
两名 reviewers 独立审查、选择纳入研究并提取数据。第三名reviewer解决任何差异。
确定了六项研究（IV级证据），包括358例MRI实例。使用卫生经济学会病例系列研究质量评估清单对研究质量进行评估。未进行描述性统计。
总体而言，我们未发现严重患者伤害的报告（0.0%），包括烧伤和外固定稳定性变化。有四份（1.1%）报告称患者感到不适或疼痛，导致MRI提前终止，无长期后遗症。
总体而言，在我们对现有文献的系统评价中未报告患者伤害事件。建议进一步开展研究，以帮助制定未来外固定患者使用MRI的指南。目前，尚无临床证据表明MRI在肢体外固定患者中不安全；然而，这一话题仍存在争议。在该患者群体中，使用MRI的益处可能超过潜在的轻微风险，作者建议不要全面禁止外固定患者使用MRI。
治疗性IV级。
