Prosthesis replacement in Mason III radial head fractures: A meta-analysis

Introduction: This present study was to evaluate the clinical efficacy of prosthesis replacement (PR) for patients with Mason III radial head fractures (RHF) compared with open reduction and internal fixation (ORIF). Methods: We retrieved the relevant trials up to September 2013 from several public databases, mainly including PubMed, Embase, Springer, Elsevier Science Direct, Cochrane Library, Google scholar, CNKI and Wanfang database. Weighted mean difference (WMD) or odds ratio (OR) and their 95% confidence intervals (CI) were calculated to compare the clinical outcomes between PR and ORIF. Results: A total of 9 studies including 365 patients with Mason III RHF (169 patients treated with PR and 196 patients treated with ORIF) were reanalyzed in the meta-analysis. The results showed that the patients with Mason III RHF receiving PR, compared with the ORIF ones, had a significantly higher percentage of postoperative excellent and good rate (OR=3.48, 95% CI = 1.98 to 6.11, P<0.0001), better Broberg and Morrey elbow scores (WMD = 9.79,95% CI = 4.22 to 15.36, P= 0.0006) and significantly lower postoperative complications (OR = 0.33, 95% CI= 0.16 to 0.69, P=0.003). Conclusions: Although the results of this study supported the use of PR in the treatment of Mason III RHF in Chinese population with short-term outcomes, the evidences are of low quality and further studies were required for confirming these results in the longer term on other populations. (C) 2015 Elsevier Masson SAS. All rights reserved.