Intramedullary pin versus plate for treatment of displaced mid-shaft clavicle fractures: a meta-analysis
10.3760/cma.j.issn.1671-7600.2014.07.009
- VernacularTitle:髓内钉与钢板内固定治疗移位型锁骨中段骨折疗效比较的Meta分析
- Author:
Min CHEN
;
Nan JIANG
;
Bin YU
- Publication Type:Journal Article
- Keywords:
Clavicle;
Fracture fixation,internal;
Bone nails;
Bone plates;
Meta-analysis
- From:
Chinese Journal of Orthopaedic Trauma
2014;16(7):591-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy of intramedullary pin versus plate fixation for displaced mid-shaft clavicle fractures.Methods The databases,PubMed,CENTAL and CBM,were searched according to the standards of the Cochrane Collaboration for all the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing intramedullary pin with plate fixation for treatment of displaced mid-shaft clavicle fractures.In addition,hand search was also conducted in relevant journals.Time limit for search was from the beginning till December 2013.Trial quality was assessed using the modified Jadad scale and effective data were pooled for Meta analysis with software RevMan5.2.7,including wound infection,hospital stay,wound size,intraoperative blood loss,operation duration,implant irritation,implant problems,delayed union,malunion,nonunion,total complications and Constant scoring.Results Three RCTs and 7 CCTs with 697 patients were included in our study.The modified Jadad scoring showed fine quality of the 10 trials.Intramedullary fixation was significantly superior to plate fixation in wound size,intraoperative blood loss,operation duration,hospital stay,wound infection,and symptomatic hardware (P ＜ 0.05),but led to a significantly higher rate of implant problems (P ＜ 0.05).However,no significant differences were identified in total complication rate,delayed union,nonunion,malunion or Constant score (P ＞ 0.05).Conclusions The superiority of intramedullary fixation for displaced mid-shaft clavicle fracture lies in its advantages of minimally invasion,such as limited incision,less intraoperative bleeding,shorter operation time and hospital stay,less wound infection and implant irritation.Ahhough intramedullary fixation may lead to a higher rate of implant problems,it shows no significant differences from plate fixation in bone healing and functional recovery.
