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European Journal of Orthopaedic Surgery & Traumatology

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26-12-2023 | Tibia Fracture | General Review

Plating as a reduction aid prior to intramedullary nailing of tibia fractures: a systematic review and meta-analysis

Authors: Kyle Gouveia, Philip Hache, Herman Johal

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2024

Abstract

Purpose

The purpose of this meta-analysis is to analyse the literature on plate-assisted reduction during intramedullary nailing of tibial shaft fractures and to compare the rates of infection and nonunion.

Methods

The databases Medline, Embase, and Web of Science were searched from inception to February 2022 for literature comparing plate-assisted reduction during intramedullary nailing of extra-articular tibia fractures to standard, closed means of reduction. Data were extracted and pooled in a random effects meta-analysis for the primary outcomes of nonunion and infection risk.

Results

Five comparative studies were identified including 520 total patients, of which 151 underwent tibial nailing with the use of plate-assisted reduction with an average follow-up time of 17.9 months. Approximately two-thirds of patients retained the plate used to assist reduction during intramedullary nailing (102 of 151). Pooled analysis of the infection rates found no significant difference with plate-assisted intramedullary nailing (Risk Ratio [RR] 0.90, 95% CI 0.49–1.65, p = 0.72), and for nonunion rates, there was also no significant difference with plate-assisted intramedullary nailing (Risk Ratio [RR] 0.80, 95% CI 0.40–1.60, p = 0.53).

Conclusions

Plate-assisted reduction during intramedullary nailing of tibia shaft fractures was not associated with an increased risk for nonunion or infection, and can be safely applied as an adjunct for reduction in challenging fracture patterns, without the need for later removal. However, evidence is quite limited and further investigation into the use of provisional plating as a technique is needed as its use in intramedullary nailing continues to expand.

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Title: Plating as a reduction aid prior to intramedullary nailing of tibia fractures: a systematic review and meta-analysis
Authors: Kyle Gouveia
Philip Hache
Herman Johal
Publication date: 26-12-2023
Publisher: Springer Paris
Keyword: Tibia Fracture
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03801-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Plating as a reduction aid prior to intramedullary nailing of tibia fractures: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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