Meta-analysis of flexible intramedullary nailing and external fixation for pediatric femoral shaft fractures
10.3969/j.issn.2095-4344.2015.31.028
- VernacularTitle:弹性髓内钉与外固定架修复儿童股骨干骨折的Meta分析
- Author:
Yongcheng GUO
;
Guangwei XING
;
Bing XIA
;
Guoming FENG
;
Yanzhao DONG
;
Xueqiang NIU
;
Qianyi HE
- Publication Type:Journal Article
- Keywords:
Femur;
Fractures,Bone;
Bone Nails;
Postoperative Complications;
Meta-Analysis;
Evidence-Based Medicine
- From:
Chinese Journal of Tissue Engineering Research
2015;(31):5072-5078
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Flexible intramedulary 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 systematicaly evaluate the therapeutic effects of flexible intramedulary 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 controled trials of flexible intramedulary 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 overal 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 folowing flexible intramedulary nailing. No significant differences in other complications were found between the two groups. These results confirm that compared with external fixation, elastic intramedulary nail has fewer complications and faster fracture healing. Elastic intramedulary 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.
