Abstract:

BACKGROUND: With the development of minimally invasive technique, more and more forearm fracture, especially in children, was treated by elastic stable intramedullary nailing. Recently, elastic stable intramedullary nailing was also used in elder children, even adults. In particular, this technique has obtained good curative effects for open fracture and unstable fracture.
OBJECTIVE: To evaluate the clinical effectiveness and safety of elastic intramedullary nail and plate fixation for double fracture of forearm using evidence-based medicine.
METHODS: We retrieved PubMed, Embase, Cochrane Library, China Biology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software.
RESULTS AND CONCLUSION: A total of 7 randomized controlled trials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P < 0.000 1), the time of fracture healing was shorter (P < 0.000 01), and the hospitalization time was shorter (P < 0.000 01). In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.

Key words: internal fixators, forearm, fractures, bone, meta-analysis