A meta-analysis of expandable intramedullary nail versus interlocking intramedullary nail for treatment of tibia fracture

doi:10.3969/j.issn.2095-4344.2015.53.020

Abstract

Abstract:

BACKGROUND: At present, a large number of studies have proved that the expandable intramedullary nail and interlocking intramedullary nail are effective in treatment of limb fractures. However, for the treatment of tibial fractures, the advantages and disadvantages of the two kinds of fixation methods are still inconclusive.

OBJECTIVE: To systematically review the effectiveness and safety of expandable intramedullary nail and interlocking intramedullary nail for treatment of tibia fracture.

METHODS: We searched PubMed, Embase, The Cochrane Library (Issue 1, 2015), CBM, CNKI, VIP and WanFang Data for articles concerning randomized controlled trials on expandable intramedullary nail versus interlocking intramedullary nail published from inception to January 1, 2015. The key words were “tibia, fracture, tibia fracture, tibia fractures, expandable intramedullary nail, expandable nail, intramedullary nail, interlocking intramedullary nail”. Meta-analysis was performed using RevMan 5.2 software.

RESULTS AND CONCLUSION: Ten randomized controlled trials involving 574 patients were included. The results of meta-analysis showed that, compared with interlocking intramedullary nail, expandable intramedullary nail was shorter in operation time [MD=-23.42, 95%CI (-26.94, -19.90), P < 0.000 01], less in intraoperative hemorrhage [MD=-47.64, 95%CI (-52.21, -43.09), P < 0.000 01], less in fluoroscopy times [MD=-1.40, 95%CI (-1.49, -1.30), P < 0.000 01], shorter in union time [MD=-30.84, 95%CI (-35.27, -26.41), P < 0.000 01], and less in incidence of complications [OR=0.20, 95%CI (0.10, 0.40), P < 0.000 01]. The Johner-Wruh scores showed on significant difference. These findings suggest that expandable intramedullary nail for tibia fracture has more advantages than interlocking intramedullary nail. That is to say, the expandable intramedullary nail is an improved nail of interlocking intramedullary nail, but a large sample of high quality randomized controlled trials are still needed to confirm the conclusion.

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

CLC Number:

R318

Wang Wen-da, Jin Qi, Ruan Wen-feng, Ping An-song. A meta-analysis of expandable intramedullary nail versus interlocking intramedullary nail for treatment of tibia fracture[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(53): 8670-8676.

Figures/Tables 9

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