Outcomes of Operative Treatment of Unstable Ankle Fractures: A Comparison of Metallic and Biodegradable Implants

Abstract

The outcomes after fixation of bimalleolar ankle fractures with biodegradable implants were inferior to those after fixation with metallic implants in terms of the score on the AOFAS scale and time to bone union. However, the difference in the final AOFAS score between the groups may not be clinically important. The outcomes associated with the use of biodegradable implants for the fixation of isolated lateral malleolar fractures were comparable with those for metallic implants.

Absorbable Screws Versus Metallic Screws for Distal Tibiofibular Syndesmosis Injuries: A Meta-Analysis

“…10). Also, a meta-analysis of 4 studies (16,18,20,25) comparing the operation time showed no statistically significant difference between the 2 groups (mean difference 7.64, 95% CI À3.80 to 19.09, I 2 ¼ 98%, p ¼ .19; Fig. 11).…”

“…No statistically significant difference was seen in the total cost between the AS and MS groups (9698.8, range 7426.5 to 13,485.6; and 10,347.2, range 82 21.5 to 13,169.2 renminbi, respectively; p ¼ .47). Five studies (11,15,16,18,21) compared the fracture healing time between the 2 groups, and the difference was not statistically significant (mean difference À1.88, 95% CI À3.51 to À0.26, I 2 ¼ 93%, p ¼ .02; Fig. 10).…”

“…After reading the titles and abstracts, 244 studies that were duplicates or did not meet the eligible criteria were excluded. After reading the full text, 102 reports were excluded, and 16 published RCTs (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), with a total of 1208 patients, were ultimately included in the meta-analysis. A flow diagram of the study screening procedure and the results are shown in Fig.…”

“…The number of patients requiring reoperation was reported in 9 studies (11,(14)(15)(16)(17)(18)20,24,26) with 669 patients. The meta-analysis showed that the incidence of reoperation in the MS group was significantly greater than that in the AS group (RR 0.08, 95% CI 0.03 to 0.18, I 2 ¼ 77%, p < .01; Fig.…”

“…8) These data suggested minimal heterogeneity between the studies, and visual inspection of the funnel plots did not suggest the presence of a publication bias. The incidence of heterotopic ossification was calculated in 4 studies (11,16,20,25) with 472 patients. No significant difference was observed between the AS and MS groups (RR 1.93, 95% CI 0.21 to 17.62, I 2 ¼ 51%, p ¼ .56; Fig.…”