Radial head arthroplasty versus Open reduction and internal fixation for the treatment of the terrible triad injury of the elbow: a systematic review and Meta-analysis

doi:10.3877/cma.j.issn.2096-0263.2023.04.007

Abstract

Abstract:

Objective

The differences of efficacy between RHA and ORIF for the treatment of terrible triad injury of the elbow (TTIE) were compared in this Meta-analysis.

Methods

We searched the literatures published in databases such as Pubmed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (Central), Cinahl, Medline, Cochrane Library, CBM, CNKI, etc., from March 2013 to March 2022. A total of 1, 141 related literatures were retrieved, and 12 literatures were finally included. Data from included studies were extracted independently by two reviewers, analysed using RevMan 5.4, and study quality was assessed according to Cochrane systematic analysis.

Results

On surgical treatment for TTIE, we found that forearm extension range of motion after surgery in RHA group [95% CI: -5.53, -1.50, P<0.001] was superior to ORIF, with lower incidence of complications [95% CI: 0.20, 0.79, P<0.001], and the difference was statistically significant. Meanwhile, there was no statistically significant difference in terms of Mayo Elbow Performance Score (MEPS) Score, Disabilities of the Arm, Shoulder and Hand (DASH) Score and elbow range of motion (flexion–extension arc).

Conclusions

Compared with the ORIF, the RHA group had better forearm extension range of motion and fewer complications after surgery, so RHA was superior to ORIF in the treatment of TTIE.

Key words: Terrible triad injury of the elbow, Radial head arthroplasty, Open reduction internal fixation

Yunlu Wang, Xiyong Li, Lun Liu, Peng Zhang, Pengfei Han, Xiaodong Li. Radial head arthroplasty versus Open reduction and internal fixation for the treatment of the terrible triad injury of the elbow: a systematic review and Meta-analysis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(04): 240-246.

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Figures/Tables 4

References 27

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作者	研究性质	国家	发表年份	组别	病例数	年龄/岁	性别比（男/女）	结局指标	改良Jadad评分
Aff等^[8]	前瞻性	埃及	2020	RHA	16	40.4±14.9	17/13	⑴⑵⑶	6
Aff等^[8]	前瞻性	埃及	2020	ORIF	14	40.4±14.9	17/13	⑴⑵⑶	6
Giannicola等^[9]	前瞻性	意大利	2015	RHA	16	53.13±12.49 48.89±20.25	7/9	⑴⑵⑶⑷	6
Giannicola等^[9]	前瞻性	意大利	2015	ORIF	9	53.13±12.49 48.89±20.25	5/4	⑴⑵⑶⑷	6
Hou等^[10]	回顾性	中国	2020	RHA	3	37.33±5.86 33.81±7.30	1/2	⑴⑵⑶⑷	4
Hou等^[10]	回顾性	中国	2020	ORIF	21	37.33±5.86 33.81±7.30	15/6	⑴⑵⑶⑷	4
Klug等^[11]	回顾性	德国	2020	RHA	26	53.9±43.57	8/18	⑴⑵⑶	4
Klug等^[11]	回顾性	德国	2020	ORIF	51	-	-	⑴⑵⑶	4
Li等^[12]	回顾性	中国	2018	RHA	24	37.5±75.63	34/20	⑴⑷	4
Li等^[12]	回顾性	中国	2018	ORIF	30	37.5±75.63	34/20	⑴⑷	4
Liu等^[13]	回顾性	中国	2018	RHA	4	48.23±10.95	29/12	⑴⑶⑷	4
Liu等^[13]	回顾性	中国	2018	ORIF	37	48.23±10.95	29/12	⑴⑶⑷	4
Matar等^[14]	回顾性	英国	2017	RHA	9	55.67±8.56	4/5	⑴⑶⑷	5
Matar等^[14]	回顾性	英国	2017	ORIF	4	61.5±12.26	0/4	⑴⑶⑷	5
Pierrart等^[15]	回顾性	法国	2015	RHA	7	-	-	⑴⑶	3
Pierrart等^[15]	回顾性	法国	2015	ORIF	10	-	-	⑴⑶	3
Watters等^[16]	回顾性	美国	2014	RHA	30	48±64.49	21/18	⑶	2
Watters等^[16]	回顾性	美国	2014	ORIF	9	48±64.49	21/18	⑶	2
Yan等^[17]	回顾性	中国	2015	RHA	20	36.54±6.58	11/9	⑴⑶⑷	6
Yan等^[17]	回顾性	中国	2015	ORIF	19	35.51±6.28	7/12	⑴⑶⑷	6
Zhang等^[18]	回顾性	中国	2014	RHA	2	-	-	⑴⑶⑷	5
Zhang等^[18]	回顾性	中国	2014	ORIF	18	-	-	⑴⑶⑷	5
Zheng等^[19]	回顾性	中国	2020	RHA	13	47.08±6.20	9/4	⑴	3
Zheng等^[19]	回顾性	中国	2020	ORIF	10	48.20±7.22	6/4	⑴	3

作者	研究性质	国家	发表年份	组别	病例数	年龄/岁	性别比（男/女）	结局指标	改良Jadad评分
Aff等^[8]	前瞻性	埃及	2020	RHA	16	40.4±14.9	17/13	⑴⑵⑶	6
Aff等^[8]	前瞻性	埃及	2020	ORIF	14	40.4±14.9	17/13	⑴⑵⑶	6
Giannicola等^[9]	前瞻性	意大利	2015	RHA	16	53.13±12.49 48.89±20.25	7/9	⑴⑵⑶⑷	6
Giannicola等^[9]	前瞻性	意大利	2015	ORIF	9	53.13±12.49 48.89±20.25	5/4	⑴⑵⑶⑷	6
Hou等^[10]	回顾性	中国	2020	RHA	3	37.33±5.86 33.81±7.30	1/2	⑴⑵⑶⑷	4
Hou等^[10]	回顾性	中国	2020	ORIF	21	37.33±5.86 33.81±7.30	15/6	⑴⑵⑶⑷	4
Klug等^[11]	回顾性	德国	2020	RHA	26	53.9±43.57	8/18	⑴⑵⑶	4
Klug等^[11]	回顾性	德国	2020	ORIF	51	-	-	⑴⑵⑶	4
Li等^[12]	回顾性	中国	2018	RHA	24	37.5±75.63	34/20	⑴⑷	4
Li等^[12]	回顾性	中国	2018	ORIF	30	37.5±75.63	34/20	⑴⑷	4
Liu等^[13]	回顾性	中国	2018	RHA	4	48.23±10.95	29/12	⑴⑶⑷	4
Liu等^[13]	回顾性	中国	2018	ORIF	37	48.23±10.95	29/12	⑴⑶⑷	4
Matar等^[14]	回顾性	英国	2017	RHA	9	55.67±8.56	4/5	⑴⑶⑷	5
Matar等^[14]	回顾性	英国	2017	ORIF	4	61.5±12.26	0/4	⑴⑶⑷	5
Pierrart等^[15]	回顾性	法国	2015	RHA	7	-	-	⑴⑶	3
Pierrart等^[15]	回顾性	法国	2015	ORIF	10	-	-	⑴⑶	3
Watters等^[16]	回顾性	美国	2014	RHA	30	48±64.49	21/18	⑶	2
Watters等^[16]	回顾性	美国	2014	ORIF	9	48±64.49	21/18	⑶	2
Yan等^[17]	回顾性	中国	2015	RHA	20	36.54±6.58	11/9	⑴⑶⑷	6
Yan等^[17]	回顾性	中国	2015	ORIF	19	35.51±6.28	7/12	⑴⑶⑷	6
Zhang等^[18]	回顾性	中国	2014	RHA	2	-	-	⑴⑶⑷	5
Zhang等^[18]	回顾性	中国	2014	ORIF	18	-	-	⑴⑶⑷	5
Zheng等^[19]	回顾性	中国	2020	RHA	13	47.08±6.20	9/4	⑴	3
Zheng等^[19]	回顾性	中国	2020	ORIF	10	48.20±7.22	6/4	⑴	3

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