Cable Pin System versus K-wire Tension Band Fixation for Patella Fractures in Chinese Han Population: A Meta-analysis

This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane library, China National Knowledge Infrastructure（CNKI）, Chinese Wan Fang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration＇s REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis（426 fractures treated with CPS and 506 fractures treated with KTB）. There were significant differences in duration of hospital stay [mean difference（MD）=–1.07; 95% confidence interval（CI）： –1.71 to –0.43], fracture healing time（MD=–1.23; 95% CI： –1.68 to –0.77）, flexion degree of knee joint at 6 th month after operation（MD=14.82; 95% CI： 10.93 to 18.71）, incidence of postoperative complication [risk ratio（RR）=0.16; 95% CI： 0.09 to 0.27] and excellent-good rate of B？stman score（RR=1.09; 95% CI： 1.03 to 1.16） between the CPS group and KTB group, while no significant difference was found in operative time between the two groups（MD=–4.52; 95% CI： –11.70 to 2.67）. For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6 th month after operation, incidence of postoperative complication and excellent-good rate of B？stman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.

The Role of Prophylactic Antibiotics for Percutaneous Procedures in Orthopaedic Surgery

Introduction This study investigates the current practice of surgeons in the United Kingdom with regards to their usage of prophylactic antibiotics for percutaneous orthopaedic procedures. Methods An electronic survey of 10 questions was devised and sent to all members of the British Orthopaedic Association. Three hundred and three replies were obtained (172 consultants, 131 trainees). Results Only half the numbers of orthopaedic surgeons would routinely use antibiotics for percutaneous K-wire fixation. Of the other half, 28% would never prescribe antibiotics and 22% would use them in special circumstances only. These ‘special circumstances’ were also not standardised. 92% of those who did prescribe antibiotics would administer single dose only and the majority (90%) would administer them during induction. There was no significant difference between trainees and consultants or between different orthopaedic procedures with regards to whether prophylactic antibiotics were prescribed or not. Discussion This survey highlights the split of opinion amongst practising orthopaedic surgeons as to the necessity or otherwise of antibiotic prophylaxis in percutaneous orthopaedic procedures. There are no reliable guidelines and further work should be carried out to investigate this subject.