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A meta-analysis of External Fixator Versus Intramedullary Nails for Open Tibial Fracture Fixation.
- Source :
-
Journal of Orthopaedic Surgery & Research . 2014, Vol. 9 Issue 1, p142-155. 14p. 1 Diagram, 3 Charts. - Publication Year :
- 2014
-
Abstract
- Background To compare the clinical outcomes of external fixator (EF) and intramedullary nails (IN) in the treatment of open tibial fractures. Methods We searched seven electronic databases (PubMed, MEDLINE, EMBASE, OVID, Cochrane library, CNKI, and CBM) for trials of tibial fracture fixation published from 1980 to 2013. The indicators including postoperative infection, malunion, nonunion, soft tissue injury, delayed healing, and healing time were used for quantitative outcome assessments. Results A total of nine trials involving 532 patients (EF, n = 253; IN, n = 279) with open tibia fractures were included in this meta-analysis. The results indicated that the patients undergoing IN had lower incidence of postoperative infection (risk radio [RR] = 3.85; 95% confidence intervals [CI], 2.67-5.54; P < 0.0001), malunion (RR = 2.31; 95% CI, 1.40-3.81; P = 0.001), nonunion (RR = 1.41; 95% CI, 1.06-1.88; P = 0.02) and less healing time (weighted mean difference [WMD] = 6.19; 95% CI, 1.42-10.96; P = 0.01) compared with EF. However, regarding to the soft tissue injury (RR = 0.74; 95% CI, 0.34-1.62; P = 0.45) and delayed healing (RR = 1.38; 95% CI, 0.79-2.43; P = 0.26), there is no significantly difference between EF and IN approach. Conclusion In conclusion, the use of IN is more effective than EF and may be considered as first-line approach in fixation of open tibial fractures. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ORTHOPEDIC surgery
*COMPOUND fractures
*CHI-squared test
*COMPARATIVE studies
*DATABASES
*MEDICAL databases
*INFORMATION storage & retrieval systems
*MEDICAL information storage & retrieval systems
*MEDLINE
*META-analysis
*ONLINE information services
*ORTHOPEDIC implants
*HEALTH outcome assessment
*SOFT tissue injuries
*TIBIA injuries
*TIME
*TRAFFIC accidents
*TREATMENT effectiveness
*DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 1749799X
- Volume :
- 9
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Orthopaedic Surgery & Research
- Publication Type :
- Academic Journal
- Accession number :
- 97924715
- Full Text :
- https://doi.org/10.1186/s13018-014-0075-6