META-ANALYSIS OF CLOSED CANNULATED SCREW FIXATION VERSUS OPEN PLATE FIXATION FOR SANDERS II, III CALCANEAL FRACTURES IN FITNESS ENTHUSIASTS AND ATHLETES

Objective: To compare closed cannulated screw fixation and open plate fixation in the treatment of Sanders II, III calcaneal fractures. Methods: Randomized controlled studies searching from PubMed, Embase and Cochrane library from the establishment of the database to September 2022. The retrieved literature was screened according to inclusion and exclusion criteria. And RevMan 5.3 software was used for Meta analysis. Results: A total of 10 studies were included with 1014 feet of 1010 cases, including 508 feet of 506 cases in the closed group (experimental group) and 506 feet of 504 cases in the open group (control group). Meta analysis results: the time to operation of the closed group was shorter than that of the open group [ MD = -2.15, 95% CI ( -3.62, -0.68 ), P < 0.05 ]; operation time of the closed group was shorter than that of the open group [ MD = -14.95, 95% CI ( -26.01, -3.90 ), P < 0.05 ]; bigger Gissane angle of the closed group [ MD = 0.98, 95% CI ( 0.28, 1.67 ), P < 0.05 ]; higher calcaneus of the closed group [ MD = 0.61, 95% CI ( 0.12, 1.11 ), P < 0.05 ]; less postoperative complications of the closed group [ OR = 0.29, 95% CI ( 0.17, 0.52 ), P < 0.05]; No statistically significant differences in postoperative Bohler Angle [ MD = 0.44, 95% CI (-0.50, 1.38), P > 0.05 ], calcaneus width [ MD = 0.78, 95% CI (-0.17, 1.72), P > 0.05 ], and AOFAS scores [ MD = 1.02, 95% CI (-3.46, 5.50), P > 0.05 ] were observed between the two groups. Conclusions: Closed cannulated screw fixation are superior to open plate fixation in the treatment of Sanders II, III calcaneal fractures with shorter operation time, and less postoperative complications. There is no significant difference between the two surgical methods in restoring ankle function.