Intramedullary nailing versus plating for distal tibia fractures in adults: a systematic review
10.3760/cma.j.issn.1671-7600.2018.02.004
- VernacularTitle:髓内钉与钢板治疗成人胫骨远端骨折的Meta分析
- Author:
Habulihan HALI
1
;
Yi YANG
;
Shayilanbieke NUERHANATI
;
Hajiaheman YEERZHATI
;
Gele JIN
Author Information
1. 新疆医科大学第一附属医院骨科中心
- Keywords:
Tibia fractures;
Bone plates;
Bone nails;
Randomized controlled trials;
Sys-tematic analysis
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(2):112-117
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the clinical efficacy and complications of in-tramedullary nailing (IMN) versus plating for distal tibia fractures in adults. Methods A comprehensive search was conducted for the randomized controlled trials from January 2005 to October 2016 on the IMN versus plating for distal tibia fractures in The Cochrane Library, Springer, Pubmed, Medline Embase, CNKI, Wanfang Data and manually as well. The quality of the included literature was evaluated accordingly. RevMan5.3 provided by Cochrane was used to analyze the data. Results A total of 7 randomized con-trolled trials (n=514) were included involving 514 participants (IMN: 267; Plating: 247). IMN achieved a significantly lower superficial infection incidence [MD=2.41, 95% CI (1.11, 5.23), P=0.03]. There were no significant differences between IMN and plating in deep infection [MD=1.43, 95% CI (0.51, 4.04), P=0.50], nonunion [MD=1.35, 95% CI (0.56, 2.38), P=0.51], malunion [MD=0.88, 95% CI (0.50, 1.57), P=0.67], delayed union [MD=0.69, 95% CI (0.26, 1.85), P=0.46],or removal of metal work [MD=1.05, 95% CI (0.81, 1.36), P=0.72]. Conclusion Since plating may lead to a significantly higher rate of superficial infection for adult distal tibial fractures than intramedullary nailing, special attention should be paid to aseptic manipulation during plating, and minimally invasive pro-cedures and soft tissue protection measures should be taken as far as possible.
