Meta-analysis of femoral shaft fractures treated with interlocking intramedullary nail and extramedullary plate

doi:10.3969/j.issn.2095-4344.2016.17.020

Abstract

Abstract:

BACKGROUND: With deep understanding of the concept of biological fixation, more and more physicians choose interlocking intramedullary nail in the repair of femoral shaft fracture. Compared with traditional extramedullary plate, the superiority of the interlocking intramedullary nail has not been reported at present. Randomized controlled clinical study is less, and lacks of systematic evaluation.

OBJECTIVE: The results of meta-analysis were used to compare the therapeutic effects of interlocking intramedullary nail and steel plate for femoral shaft fractures.

METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database, and Vip database from 2000 to 2015 by computer to collect randomized controlled study on interlocking intramedullary nail and extramedullary plate for treatment of femoral shaft fractures. We screened the literatures that met the inclusion criteria, were strict quality evaluation of the selection. Excellent and good rate, operation time, intraoperative blood loss, hospitalization time, recovery time of knee joint function reaching 135°, knee joint function recovery time of the second operation to remove the internal fixation for reaching 135°, postoperative drainage volume, fracture healing time, nonunion or delayed union, internal fixation loosening, postoperative infection, and osteomyelitis were considered as the evaluation index of meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Collaboration.

RESULTS AND CONCLUSION: Finally 10 Chinese articles were included, including 915 patients with femoral shaft fractures. The results of meta-analysis showed that compared with extramedullary plate, interlocking intramedullary nails for femoral shaft fractures could effectively reduce the amount of blood loss, postoperative drainage, shorten operation time, hospitalization time, fracture healing time, reduce the incidence of postoperative infection, and obtain recovery of knee joint function. These results suggest that interlocking intramedullary nail for treating femoral shaft fractures has certain advantages. The interlocking intramedullary nail can be firstly selected in the permit of patient’s economic conditions and hospital conditions.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Bone Nails, Randomized Controlled Trial, Evidence-Based Medicine, Meta-Analysis

Abulimiti•Amuti, Zhang Xie-zhuo, Xu Chao, Ding Hui-yong. Meta-analysis of femoral shaft fractures treated with interlocking intramedullary nail and extramedullary plate[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(17): 2575-2584.

Figures/Tables 13

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