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...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Loay A. Salman (14150322) (author)
مؤلفون آخرون: Abdallah Al-Ani (10687939) (author), Mohammed F. A. Radi (17760267) (author), Abedallah F. Abudalou (17760270) (author), Omar M. Baroudi (17760273) (author), Abdulla A. Ajaj (17760276) (author), Mohamed Alkhayarin (17760279) (author), Ghalib Ahmed (14146800) (author)
منشور في: 2023
الموضوعات:
الوسوم: إضافة وسم
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author Loay A. Salman (14150322)
author2 Abdallah Al-Ani (10687939)
Mohammed F. A. Radi (17760267)
Abedallah F. Abudalou (17760270)
Omar M. Baroudi (17760273)
Abdulla A. Ajaj (17760276)
Mohamed Alkhayarin (17760279)
Ghalib Ahmed (14146800)
author2_role author
author
author
author
author
author
author
author_facet Loay A. Salman (14150322)
Abdallah Al-Ani (10687939)
Mohammed F. A. Radi (17760267)
Abedallah F. Abudalou (17760270)
Omar M. Baroudi (17760273)
Abdulla A. Ajaj (17760276)
Mohamed Alkhayarin (17760279)
Ghalib Ahmed (14146800)
author_role author
dc.creator.none.fl_str_mv Loay A. Salman (14150322)
Abdallah Al-Ani (10687939)
Mohammed F. A. Radi (17760267)
Abedallah F. Abudalou (17760270)
Omar M. Baroudi (17760273)
Abdulla A. Ajaj (17760276)
Mohamed Alkhayarin (17760279)
Ghalib Ahmed (14146800)
dc.date.none.fl_str_mv 2023-03-03T03:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00264-023-05740-x
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Open_versus_closed_intramedullary_nailing_of_femur_shaft_fractures_in_adults_a_systematic_review_and_meta-analysis/24967146
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Open reduction
Closed reduction
Intramedullary nail
Femur
Fractures
dc.title.none.fl_str_mv Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <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>
eu_rights_str_mv openAccess
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network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/24967146
publishDate 2023
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rights_invalid_str_mv CC BY 4.0
spelling Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysisLoay A. Salman (14150322)Abdallah Al-Ani (10687939)Mohammed F. A. Radi (17760267)Abedallah F. Abudalou (17760270)Omar M. Baroudi (17760273)Abdulla A. Ajaj (17760276)Mohamed Alkhayarin (17760279)Ghalib Ahmed (14146800)Biomedical and clinical sciencesClinical sciencesMathematical sciencesStatisticsOpen reductionClosed reductionIntramedullary nailFemurFractures<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>2023-03-03T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00264-023-05740-xhttps://figshare.com/articles/journal_contribution/Open_versus_closed_intramedullary_nailing_of_femur_shaft_fractures_in_adults_a_systematic_review_and_meta-analysis/24967146CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/249671462023-03-03T03:00:00Z
spellingShingle Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
Loay A. Salman (14150322)
Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Open reduction
Closed reduction
Intramedullary nail
Femur
Fractures
status_str publishedVersion
title Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_full Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_fullStr Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_full_unstemmed Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_short Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_sort Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
topic Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Open reduction
Closed reduction
Intramedullary nail
Femur
Fractures