Intramedullary nail fixation versus plate fixation in the treatment of displaced midshaft clavicular fractures in adults: a meta-analysis

doi:10.3969/j.issn.2095-4344.2949

Abstract

Abstract: OBJECTIVE: At present, many studies have proved that intramedullary nail and steel plate internal fixation is a better way to treat displaced midshaft clavicular fracture. However, there are relatively few comparative studies on the advantages and disadvantages of the two methods, and there are still many controversies. Through the meta-analysis of related literature, the efficacy and safety of intramedullary nail and steel plate in the treatment of adult displaced midshaft clavicular fracture were systematically evaluated.
METHODS: Through computer retrieval of PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP databases from the inception to January 2020, the literature of randomized controlled trials meeting the inclusion and exclusion criteria of intramedullary nail and steel plate in the treatment of adult displaced midshaft clavicular fracture was collected and screened, and the quality evaluation and data extraction were carried out. The operation time, incision length and upper limb function score, Constant-Murley score, and fracture healing time were used as the evaluation indexes of meta-analysis. Meta-analysis was performed using ReMan 5.3 software.
RESULTS: (1) Eight valuable articles were retrieved, among which 283 patients were treated with intramedullary nail and 271 patients were treated with steel plate internal fixation. (2) The meta-analysis results showed that the intramedullary nail group was superior to the steel plate group in terms of operation time [MD=-19.63, 95%CI(-22.72,-16.54)], incision length [MD=-3.31, 95%CI(-5.78, -0.85)], and fracture healing time [MD=-1.53, 95%CI(-2.73, -0.33)]. (3) No significant difference was found in upper limb function score [MD=-1.91, 95%CI(-5.48, 1.66)] and Constant-Murley score [MD=-0.58, 95%CI(-4.63, 3.47) between the intramedullary nail group and the steel plate group after surgery.
CONCLUSION: The results of meta-analysis showed that intramedullary nail was superior to steel plate in the operation time, incision length and fracture healing time in the treatment of displaced midshaft clavicular fracture. The above results can provide evidence for clinical use of intramedullary nail instead of steel plate internal fixation in the treatment of displaced midshaft clavicular fracture.

Key words: bone, clavicle, fracture, steel plate, intramedullary nail, randomized controlled trial, meta-analysis

CLC Number:

Li Yanle, Yue Xiaohua, Wang Pei, Nie Weizhi, Zhang Junwei, Tan Yonghai, Jiang Hongjiang. Intramedullary nail fixation versus plate fixation in the treatment of displaced midshaft clavicular fractures in adults: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 471-476.

Figures/Tables 9

References

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