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Archives of Orthopaedic and Trauma Surgery

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01-10-2011 | Orthopaedic Outcome Assessment

Reamed intramedullary nailing versus unreamed intramedullary nailing for shaft fracture of femur: a systematic literature review

Authors: Xin Duan, Tao Li, Al-Qwbani Mohammed, Zhou Xiang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2011

Abstract

Introduction

Fractures of femoral fracture are among the most common fractures encountered in orthopedic practice. Intramedullary nailing is the treatment choice for femoral shaft fractures in adults. The objective of this article is to determine the effects of reamed intramedullary nailing versus unreamed intramedullary nailing for fracture of femoral shaft in adults.

Methods

Cochrane Central Register of Controlled Trials (October 2010), PubMed (October 2010) and EMBASE (October 2010) were searched. Randomized and quasi-randomized controlled clinical trials were included. After independent study selection by two authors, data were collected and extracted independently. The methodological quality of the studies was assessed. Pooling of data was undertaken where appropriate.

Results

Seven trials with 952 patients (965 fractures) were included. Compared with unreamed nailing, reamed nailing was significantly lower reoperation rate (RR 0.25, 95% CI 0.11–0.59, P = 0.002), lower non-union rate (RR 0.20, 95% CI 0.05–0.77, P = 0.02) and lower delay union rate(RR 0.30, 95% CI 0.14–0.64, P = 0.002). There was no significant difference when comparing reamed nailing with unreamed nailing for implant failure (RR 0.51, 95% CI 0.16–1.61, P = 0.25), mortality(RR 0.94, 95% CI 0.19–4.58, P = 0.94) and acute respiratory distress syndrome(RR 1.53, 95% CI 0.37–6.29, P = 0.55). Unreamed nailing was significantly less blood loss (SMD 119.23, 95% CI 59.04–180.43, P = 0.0001).

Conclusion

Reamed intramedullary nailing has better treatment effects than unreamed intramedullary nailing for shaft fracture of femur in adults.

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Title: Reamed intramedullary nailing versus unreamed intramedullary nailing for shaft fracture of femur: a systematic literature review
Authors: Xin Duan
Tao Li
Al-Qwbani Mohammed
Zhou Xiang
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1311-8

At a glance: The STEP trials

Springer Medicine

Reamed intramedullary nailing versus unreamed intramedullary nailing for shaft fracture of femur: a systematic literature review

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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