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The Journal of Bone and Joint Surgery 80:1711 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Clayton R. Perry, M.D., Benjamin Littenberg, M.D., Loryn P. Weinstein, M.D., Madeline McCarren, Ph.D., Thomas Mead, M.L.S., Marc F. Swiontkowski, M.D., Sally A. Rudicel, M.D. and David Heck, M.D.

TO THE EDITOR:

The article "Closed Fractures of the Tibial Shaft. A Meta-Analysis of Three Methods of Treatment" (80-A: 174–183, Feb. 1998), by Littenberg et al., compared treatment with immobilization in a cast, open reduction and internal fixation, and fixation with an intramedullary rod for closed fractures of the tibial shaft. Previously published reports dealing with tibial fractures were included in, or excluded from, the meta-analysis on the basis of a list of inclusion and exclusion criteria. Among the exclusion criteria were injuries involving a joint, patients with multiple injuries, and open fractures of the tibial shaft if the results of open and closed fractures were not defined separately. The authors started with 2372 papers and, from these, gleaned nineteen that fulfilled their criteria.

In my opinion, this paper has so many deficiencies that it is meaningless. These deficiencies include the basic premise that one method of treatment will provide . . . [Full Text of this Article]


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