A meta-analysis of expandable intramedullary nail versus interlocking intramedullary nail for treatment of tibia fracture
10.3969/j.issn.2095-4344.2015.53.020
- VernacularTitle:可膨胀髓内钉与交锁髓内钉修复胫骨骨折的Meta分析
- Author:
Wenda WANG
;
Qi JIN
;
Wenfeng RUAN
;
Ansong PING
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2015;(53):8670-8676
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:At present, a large number of studies have proved that the expandable intramedul ary nail and interlocking intramedul ary 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 stil inconclusive. OBJECTIVE:To systematical y review the effectiveness and safety of expandable intramedul ary nail and interlocking intramedul ary 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 control ed trials on expandable intramedul ary nail versus interlocking intramedul ary nail published from inception to January 1, 2015. The key words were“tibia, fracture, tibia fracture, tibia fractures, expandable intramedul ary nail, expandable nail, intramedul ary nail, interlocking intramedul ary nail”. Meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:Ten randomized control ed trials involving 574 patients were included. The results of meta-analysis showed that, compared with interlocking intramedul ary nail, expandable intramedul ary 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 intramedul ary nail for tibia fracture has more advantages than interlocking intramedul ary nail. That is to say, the expandable intramedul ary nail is an improved nail of interlocking intramedul ary nail, but a large sample of high quality randomized control ed trials are stil needed to confirm the conclusion.
