Treatment of clavicular fractures using intramedullary nailing or K wire versus plating fixation:a meta analysis
10.3969/j.issn.1003-0034.2015.05.015
- VernacularTitle:髓内钉或克氏针与钢板固定治疗锁骨骨折的Meta分析
- Author:
Xue Ke ZHANG
1
;
Xin Jing ZHAO
;
Zhe ZHAO
;
Cheng Li ZHANG
;
Yun Xiu SU
;
Hua An LONG
;
Zhi MAO
;
Hui Jin ZHANG
;
Hai Li ZHANG
;
Fu Pei TANG
Author Information
1. 中国人民解放军总医院骨科
- Keywords:
Clavicle;
Fractures;
Fracture fixation,internal;
Fracture fixation,intramedullary;
Meta analysis
- From:
China Journal of Orthopaedics and Traumatology
2015;(5):454-461
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and complications rate of intramedullary(IM)nailing or K wire versus plating fixation for clavicular fractures. Methods:Pubmed,Embase,Cochrane Library databases,CNKI,VIP and Wangfang databases were searched to find all randomized or quasi randomized controlled trials of clavicle fractures using plating versus IM nailing or K wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors,da?ta were collected and extracted independently. Outcomes of postoperative shoulder functional measurement ,the efficacy and information of the operation and complications rate were meta analyzed using RevMan 5 software. Results:Nine hundreds and seventy six patients in 10 randomized controlled trials(RCTs)and 3 quasi-RCTs were involved in the meta analysis,of which 5 studies compared the K wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR)(with 95%CI)of the operation efficacy for K wire versus the plating was 3.79(1.93,7.46). The overall weighted mean difference(with 95%CI)of Constant Shoulder score for plating versus IM fixation was-1.39(-3.43, 0.65)in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70,32.32)for the overall major complications in 5 studies and 5.04(1.52,16.77)for the revision rate in 5 studies. Conclusion:The current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery ,while the post op?erative efficacy of the plating was superior to the K wire. More high quality RCTs are still needed in the future.
