Comparison Between Resorbable Plates Vs. Titanium Plates for Treatment of Zygomatic Fractures: a Systematic Review with Meta-analysis

Purpose: To compare resorbable plates with titanium plates for the fixation of zygomatic fractures, taking into account postoperative complications.

Methods: This systematic review followed the guidelines of PRISMA and the recommendations of the Cochrane Handbook and was registered in PROSPERO. The electronic search was performed in the Web of Science, PubMed, Virtual Health Library, and Cochrane Library databases and in the gray literature. The study selection and the data extraction were performed by three calibrated and independent researchers. The assessment of the risk of bias in the studies was performed using the Cochrane Risk of Bias Tool for clinical trials. Meta-analyses were performed using Review Manager Software version 5.3, using the Peto's Odds Ratios (PORs), and when I > 30, the random effect model was used. The evaluation of the quality of the evidence was carried out through GRADE.

Results: A total of 2651 studies were screened and only nine were included; 7 of which were used for quantitative assessment. The follow-up time for patients ranged from 6 months to 5 years. All studies showed a low risk of bias in the "incomplete outcome data" domain. The need for plate removal (POR: 0.11, 95% CI: 0.02 to 0.81, I = 0%) and dehiscence (POR 0.12, 95% CI 0.02 to 0.63, I = not applied) was lower for the group of patients who used resorbable plates than for titanium plates.

Conclusion: There was no difference in the occurrence of infection, diplopia, or paresthesia between the fixation methods. Resorbable plates showed better postoperative clinical performance.