Prise en charge actualisée des pseudarthroses diaphysaires aseptiques du tibia : revue systématique - 03/09/21

Contemporary management of aseptic diaphyseal tibia non-unions–A systematic review

Doi : 10.1016/j.rcot.2021.06.011

Franklin Fortuin, Marilize Burger, Nando Ferreira ^⁎
Stellenbosch university, faculty of medicine and health sciences, department of orthopedic surgery, Cape Town, South Africa

^⁎Auteur correspondant. Stellenbosch university, faculty of medicine and health sciences, department–tumour, reconstruction and sepsis, department of Orthopedic Surgery, Cape Town, South AfricaStellenbosch university, faculty of medicine and health sciences, department–tumour, reconstruction and sepsis, department of Orthopedic SurgeryCape TownSouth Africa

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 03 September 2021
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Abstract

Introduction

Tibia fractures are the most common long bone injuries encountered in the trauma population. The majority are treated successfully but non-union remains a common complication. A systematic review of current evidence regarding the management for aseptic diaphyseal tibial non-unions was undertaken.

Methods

A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), was conducted.

Results

A total of 632 publications were screened for inclusion. Full text review of 91 studies resulted in 26 publications being retained for final review. The majority of patients included in the studies either underwent exchange nailing (n=315) or primary intramedullary nailing (n=174) with respective union rates of 88% and 95% being achieved. The highest union rate (97%) was achieved with the use of fine wire external fixation. The major adjuvant treatment modalities were fibula osteotomies (n=372; 41%), fixation dynamization (n=208; 23%) and bone grafting (n=183; 20%).

Conclusion

The lack of standardization in reporting of outcomes and the diversity of management strategies employed precludes definitive conclusions or recommendations. Further research is required to ascertain the ideal treatment strategy in the management of aseptic tibial diaphyseal non-unions.

Level of evidence

IV.

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Keywords : Non-union, Tibia, Outcome, External fixation, Exchange nailing

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology : Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.