Reamed versus unreamed intramedullary nailing for tibial fractures in adults: a systematic review

doi:10.3969/j.issn.2095-4344.2016.39.021

Abstract

Abstract:

BACKGROUND: At present, the clinical application of intramedullary nail in the treatment of tibial shaft fractures has achieved good results. However reamed and unreamed intramedullary nail in repair of tibial fractures in adults remains controversial.

OBJECTIVE: To evaluate clinical efficacy and safety of reamed versus unreamed intramedullary nailing for the treatment of tibial fractures in adults.

METHODS: The literature related to application of reamed or unreamed intramedullary nailing for tibial fractures published from 1980 to 2015 were searched from Springer, PubMed, and Wanfang database. Related Chinese and English journals of orthopedics were hand-searched. All randomized controlled trials were collected. RevMan5.0 provided by Cochrane was used to analyze the data.

RESULTS AND CONCLUSION: Seven randomized controlled trials were included according to inclusion criteria, including 1 331 patients. There were 682 cases in the reamed intramedullary nailing group and 649 cases in the unreamed intramedullary nailing group. Meta-analysis results showed that compared with the reamed intramedullary nailing group, implant failure rate was significantly higher in the unreamed intramedullary nailing group [MD=0.37, 95% CI (0.24, 0.57), P < 0.000 01], and nonunion rate was significantly higher [MD=0.54, 95% CI (0.31, 0.93), P=0.03]. There was no significant difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate. Results suggested that no difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate was found in reamed and unreamed intramedullary nailing in the repair of adult tibial fractures. Reamed intramedullary nailing has advantages of low implant failure rate and nonunion rate.

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, Prostheses and Implants, Tissue Engineering

CLC Number:

R318

Nuerhanati•Shayilanbieke, Jin Ge-le, Yang Yi, Li Zhong-wei, Yeerzhati•Hazhaheman. Reamed versus unreamed intramedullary nailing for tibial fractures in adults: a systematic review[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(39): 5912-5918.

Figures/Tables 3

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