Factors determining outcome of corrective osteotomy for malunited paediatric forearm fractures: a systematic review and meta-analysis

J Hand Surg Eur Vol. 2017 Oct;42(8):810-816. doi: 10.1177/1753193417711684. Epub 2017 Jun 15.

Abstract

The aim of this study was to identify predictors of a superior functional outcome after corrective osteotomy for paediatric malunited radius and both-bone forearm fractures. We performed a systematic review and meta-analysis of individual participant data, searching databases up to 1 October 2016. Our primary outcome was the gain in pronosupination seen after corrective osteotomy. Individual participant data of 11 cohort studies were included, concerning 71 participants with a median age of 11 years at trauma. Corrective osteotomy was performed after a median of 12 months after trauma, leading to a mean gain of 77° in pronosupination after a median follow-up of 29 months. Analysis of variance and multiple regression analysis revealed that predictors of superior functional outcome after corrective osteotomy are: an interval between trauma and corrective osteotomy of less than 1 year, an angular deformity of greater than 20° and the use of three-dimensional computer-assisted techniques.

Level of evidence: II.

Keywords: Corrective osteotomy; child; forearm; fracture; malunion; radius.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Fractures, Malunited / surgery*
  • Humans
  • Male
  • Osteotomy*
  • Radius Fractures / surgery*
  • Treatment Outcome
  • Ulna Fractures / surgery*