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Amputation Versus Limb Reconstruction for Fibula Hemimelia: A Meta-analysis
Aissam Elmherig1, Abdulaziz F Ahmed1, Abdelsalam Hegazy2
1Section of Orthopedics, Department of Surgery, Hamad General Hospital.
Journal of Pediatric Orthopedics
|January 24, 2020
Summary
Amputation offers better patient satisfaction and fewer complications than limb reconstruction for fibula hemimelia (a common congenital bone deficiency). This systematic review found amputation led to higher satisfaction and less surgical burden.
Area of Science:
- Orthopedic Surgery
- Congenital Limb Deficiencies
- Surgical Outcomes
Background:
- Fibula hemimelia is the most frequent congenital long bone deficiency.
- Treatment options include amputation with prosthetic fitting or limb reconstruction.
Purpose of the Study:
- To systematically review and compare amputation versus limb reconstruction for fibula hemimelia.
- To evaluate patient satisfaction and surgical complications between the two treatment modalities.
Main Methods:
- Systematic review and meta-analysis of studies from 1951-2019.
- Searched MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane Registry.
- Utilized random effect models for comparisons of patient satisfaction and surgical complications.
Main Results:
- Seven retrospective cohort studies with 169 cases were included.
- Amputation showed significantly higher patient satisfaction (OR 6.8) compared to limb reconstruction.
- Limb reconstruction had a higher odds ratio for complications (OR 28) and more procedures per patient (4.2 vs 1.5).
Conclusions:
- Amputation appears to provide better patient satisfaction with fewer surgical complications and procedures for fibula hemimelia.
- Lack of uniform protocols hinders accurate comparison of treatment outcomes.
