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Surgical Interventions for the Treatment of Supracondylar Humerus Fractures in Children: Protocol of a Systematic
Oreste Lemos Carrazzone1, João Carlos Belloti1, Fabio Teruo Matsunaga1
1Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Insights
This systematic review evaluates surgical treatments for pediatric supracondylar humerus fractures (SHFC), aiming to clarify the best interventions for function and complications. Evidence will guide clinical practice and future research on SHFC management.
Area of Science:
- Pediatric Orthopedics
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Supracondylar humerus fractures in children (SHFC) present significant risks, including functional deficits, deformities, and nerve damage.
- Current standard treatment involves closed reduction and percutaneous Kirschner wire fixation, yet optimal techniques remain debated.
- Lack of consensus necessitates a comprehensive review of existing evidence to guide treatment decisions.
Purpose of the Study:
- To systematically review surgical interventions for Gartland type II and III SHFC.
- To assess the impact of surgical treatments on function, complications, and errors.
- To evaluate clinical outcomes like range of motion and pain, alongside radiographic results.
Main Methods:
- Systematic review of randomized controlled trials and quasi-randomized controlled trials.
- Searches conducted across major databases (Cochrane, PubMed, LILACS, EMBASE) and clinical trial registries.
- Risk of bias assessed using the Cochrane Risk of Bias Tool; data analyzed for risk ratios and mean differences.
Main Results:
- Study searches and data extraction are underway.
- Final results are anticipated in the coming months, with publication expected by end of 2018.
- Funding provided by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
Conclusions:
- This review will provide crucial evidence on the effectiveness of surgical treatments for SHFC.
- Findings will inform clinical practice by highlighting intervention efficacy and potential complications.
- Results will serve as a foundation for future research in pediatric supracondylar humerus fracture management.
Background:
The treatment of supracondylar humerus fracture in children (SHFC) is associated with complications such as functional deficit, residual deformity, and iatrogenic neurological damage. The standard treatment is closed reduction and percutaneous Kirschner wire fixation with different configurations. Despite this fact, there is still no consensus on the most effective technique for the treatment of these fractures.
Objective:
The aim of this systematic review will be to evaluate the effect of surgical interventions on the treatment of Gartland type II and III SHFC by assessing function, complications, and error as primary outcomes. Clinical outcomes such as range of motion and pain and radiographic outcomes will also be judged.
Methods:
A systematic review of randomized controlled trials or quasi-randomized controlled trials evaluating the surgical treatment of SHFC will be carried out in the Cochrane Central Register of Controlled Trials, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Excerpta Medica Database. The search will also occur at ongoing and recently completed clinical trials in selected databases. Data management and extraction will be performed using a data withdrawal form and by analyzing the following: study method characteristics, participant characteristics, intervention characteristics, results, methodological domains, and risk of bias. To assess the risk of bias of the included trials, the Cochrane Risk of Bias Tool will be used. Dichotomous outcome data will be analyzed as risk ratios, and continuous outcome data will be expressed as mean differences, both with 95% confidence intervals. Also, whenever possible, subgroup analysis, sensitivity analysis, and assessment of heterogeneity will be performed.
Results:
Following the publication of this protocol, searches will be run and included studies will be deeply analyzed. We hope to obtain final results in the next few months and have the final paper published by the end of 2018. This study was funded by a government-based noncommercial agency, Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
Conclusions:
This study may provide surgical treatment effects evidence for SHFC. The results will assist clinical practice by demonstrating the effectiveness and potential complications of these interventions and might serve as a reference for future clinical trials on the topic.
Trial Registration:
PROSPERO CRD42014009304; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=9304 (Archived by WebCite at http://www.webcitation.org/6usiDHzD7).
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