Meta-analysis of flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures

doi:10.3969/j.issn.2095-4344.2015.31.028

Abstract

Abstract:

BACKGROUND: Flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures are two common methods in the clinic. It remains controversial which fixation methods are better.
OBJECTIVE: To systematically evaluate the therapeutic effects of flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures.
METHODS: A computer-based search was performed on PubMed, Embase, Medline, and Cochrane library for literatures on clinical controlled trials of flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures published before November 25, 2014. Literature language was not limited. The age of subjects was from 3 to 15 years. Modified Jadad was utilized to assess methodological quality of the included studies.
Meta-analysis was carried out using Stata 12.0 software.
RESULTS AND CONCLUSION: Six papers involving 237 patients were included. Meta-analysis results showed that compared with external fixation, a low incidence of overall complications [relative risk (RR)=0.30, 95% confidence interval (CI): 0.19-0.46; P < 0.001] and pin-hole infection (RR=0.286, 95%CI: 0.13-0.61; P= 0.001), but a high risk of needle tail irritation (RR=1.86, 95%CI: 1.35-2.56; P < 0.001) were found following flexible intramedullary nailing. No significant differences in other complications were found between the two groups. These results confirm that compared with external fixation, elastic intramedullary nail has fewer complications and faster fracture healing. Elastic intramedullary nail is recommended for single pediatric femoral shaft fractures. However, external fixation is a better option for high energy injury of lower limbs, multiple trauma or severely soft tissue injury.

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: Femur, Fractures, Bone, Bone Nails, Postoperative Complications, Meta-Analysis, Evidence-Based Medicine

CLC Number:

R318

Guo Yong-cheng, Xing Guang-wei, Xia Bing, Feng Guo-ming, Dong Yan-zhao, Niu Xue-qiang, He Qian-yi. Meta-analysis of flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(31): 5072-5078.

Figures/Tables 10

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