Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
<h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures.</p><h3>Methods</h3><p dir="ltr">Four dat...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , |
| منشور في: |
2023
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| الملخص: | <h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures.</p><h3>Methods</h3><p dir="ltr">Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines.</p><h3>Results</h3><p dir="ltr">A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS).</p><h3>Conclusion</h3><p dir="ltr">This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies.</p><h2>Other Information</h2><p dir="ltr">Published in: International Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00264-023-05740-x" target="_blank">https://dx.doi.org/10.1007/s00264-023-05740-x</a></p> |
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