Article

Purpose - Using a network meta-analysis approach, our study aims to develop a
ranking of the six surgical procedures, that is, Plate, titanium elastic nail
(TEN), tension band wire (TBW), hook plate (HP), reconstruction plate (RP) and
Knowles pin, by comparing the post-surgery constant shoulder scores in patients
with clavicular fracture (CF). Methods - A comprehensive search of electronic
scientific literature databases was performed to retrieve publications
investigating surgical procedures in CF, with the stringent eligible criteria,
and clinical experimental studies of high quality and relevance to our area of
interest were selected for network meta-analysis. Statistical analyses were
conducted using Stata 12.0. Results A total of 19 studies met our inclusion
criteria were eventually enrolled into our network meta-analysis, representing
1164 patients who had undergone surgical procedures for CF (TEN group = 240;
Plate group = 164; TBW group = 180; RP group = 168; HP group = 245; Knowles pin
group = 167). The network meta-analysis results revealed that RP significantly
improved constant shoulder score in patients with CF when compared with TEN, and
the post-operative constant shoulder scores in patients with CF after Plate, TBW,
HP, Knowles pin and TEN were similar with no statistically significant
differences. The treatment relative ranking of predictive probabilities of
constant shoulder scores in patients with CF after surgery revealed the surface
under the cumulative ranking curves (SUCRA) value is the highest in RP.
Conclusion - The current network meta-analysis suggests that RP may be the optimum
surgical treatment among six inventions for patients with CF, and it can improve
the shoulder score of patients with CF. Implications for Rehabilitation RP
improves shoulder joint function after surgical procedure. RP achieves stability
with minimal complications after surgery. RP may be the optimum surgical
treatment for rehabilitation of patients with CF.

Langue : ANGLAIS