Elastic stable intramedullary nailing versus plate fixation for midshaft clavicular fractures: A Meta-analysis

doi:10.3969/j.issn.2095-4344.2013.13.018

Abstract

Abstract:

BACKGROUND: This is no consensus on the choice of elastic stable intramedullary nailing or plate fixation for the treatment of midshaft clavicular fractures. Current research is limited to a small sample studies, and it is difficult to carry out a large-sample multicenter analysis.
OBJECTIVE: To evaluate the efficacy and safety of elastic stable intramedullary nailing and plate fixation for the treatment of midshaft clavicular fractures with Meta-analysis.
METHODS: The PubMed database, EMbase database, Cochrane Library, CBM database, CNKI database, VIP database and Wangfang database were searched with computer to collect the controlled trials of elastic stable intramedullary nailing versus plate fixation for midshaft clavicular fractures, and related Chinese journals were manually searched. The searching time ranged from the date of database establishment to March 2012. The trails were selected, the data were extracted and the quality was evaluated by two investigators independently.
RESULTS AND CONCLUSION: One randomized controlled trial and four retrospective controlled trials involving 388 patients were included in our Meta-analysis. The results showed the postoperative functional recovery Constant score of the elastic stable intramedullary nailing group was higher than that of the plate fixation group (P < 0.01). The average bone union time, operation time, incision length, intraoperative blood loss and the hospital stay of the elastic stable intramedullary nailing group were less than those of the plate fixation group (P < 0.01). There were no significant differences in incidence rate of complications, nonunion, implant failure, wound infection and malunion between two groups. Based on the current evidence, elastic stable intramedullary nailing for the treatment of midshaft clavicular fractures is superior to the plate fixation in the efficacy. There is no significant difference of incidence rate of complications between elastic stable intramedullary nailing and plate fixation. The results still need to be confirmed by high-quality randomized controlled trials.

Key words: bone and joint implants, evidence-based medicine of bone and joint implants, clavicle, fracture, plate, intramedullary nail, fracture healing, nonunion, infection, malunion, safety, Meta-analysis

CLC Number:

R318

Chen Hao, Zhang Jin-hong, He Zeng-liang. Elastic stable intramedullary nailing versus plate fixation for midshaft clavicular fractures: A Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(13): 2407-2414.

Figures/Tables 12

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