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Reamed or unreamed intramedullary nailing for tibial fractures: a meta-analysis / 中华创伤杂志(英文版)
Chinese Journal of Traumatology ; (6): 229-234, 2014.
Article in English | WPRIM | ID: wpr-358858
Responsible library: WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To compare the treating effects of different intramedullary nailing methods on tibial fractures in adults.</p><p><b>METHODS</b>Literature reports in both Chinese and English languages were retrieved (from the earliest available records to October 1, 2013) from the PubMed, FMJS, CNKI, Wanfang Data using randomized controlled trials (RCTs) to compare reamed and unreamed intramedullary nailing for treatment of tibial fractures. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis.</p><p><b>RESULTS</b>A total of 12 randomized controlled trials, comprising 985 patients (475 in the unreamed group and 510 in the reamed group), were eligible for inclusion in this meta-analysis. The results of meta-analysis showed that there were no statistically significant differences between the two methods in the reported outcomes of infection (RR=0.64; 95%CI, 0.39 to 1.07; P=0.09), compartment syndrome (RR=1.44; 95%CI, 0.8 to 2.41; P=0.16), thrombosis (RR=1.29; 95%CI, 0.43 to 3.87; P=0.64), time to union (WMD=5.01; 95%CI, -1.78 to 11.80; P=0.15), delayed union (nonunion) (RR=1.56; 95%CI, 0.97 to 2.49; P=0.06), malunion (RR=1.75; 95%CI, 1.00 to 3.08; P=0.05) and knee pain (RR=0.94; 95%CI, 0.73 to 1.22; P=0.66). But there was a significantly higher fixation failure rate in the unreamed group than in the reamed group (RR=4.29; 95%CI, 2.58 to 7.14; P<0.00001).</p><p><b>CONCLUSION</b>There is no significant difference in the reamed and unreamed intramedullary nailing for the treatment of tibial fractures, but our result recommends reamed nails for the treatment of closed tibial fractures for their lower fixation failure rate.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Tibial Fractures / Bone Nails / Humans / Fracture Fixation, Intramedullary / Methods Type of study: Controlled clinical trial Language: English Journal: Chinese Journal of Traumatology Year: 2014 Type: Article
Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Tibial Fractures / Bone Nails / Humans / Fracture Fixation, Intramedullary / Methods Type of study: Controlled clinical trial Language: English Journal: Chinese Journal of Traumatology Year: 2014 Type: Article