PDF(Pubmed)
Abstract：
UNASSIGNED: The fixation method of distal, extra-articular femur fractures is a controversially discussed. To ensure better stability itself, earlier mobilization and to prevent blood loss - all these are justifications for addressing the femur via reamed intramedullary nailing (RIMN). Anatomical reposition of multifragmentary fractures followed by increased risks of non-union are compelling reasons against it. The purpose of this study was to systematically review the literature for rates of non-union and wound infection, as well as blood loss and time of surgery.
UNASSIGNED: According to the PRISMA guidelines we conducted this systematic review by searching the Cochrane, PubMed, Ovid, MedLine, and Embase databases. Inclusion criteria were the modified Coleman methodology score (mCMS) >60, age >18 years, and extra-articular fractures of the distal femur. Biomechanical and animal studies were excluded. By referring to title and abstract relevant articles were reviewed independently. In the consecutive meta-analysis, we compared 9 studies and 639 patients.
UNASSIGNED: There is no statistically significant difference comparing superficial wound infections when RIMN was performed (OR = 0.50; 95% CI: 0.18 - 1.42; P = 0.19) as well as in deep wound infections (OR = 0.74; 95% CI: 0.19-2.81; P = 0.62). However, these results were not significant. We also calculated for potential differences in the rate of non-unions depending on the surgical treatment applied. Data of 556 patients revealed an overall number of 43 non-unions. There was no significant difference in rate of non-unions between both groups (OR = 0.97; 95% CI: 0.51-1.85; P = 0.92).
UNASSIGNED: No statistical difference was found in our study among RIMN and plate fixation in the treatment of distal femoral fractures with regard to the incidence of non-union and wound infections. Therefore, the indication for RIMN or plating should be made individually and based on the surgeon\'s experience.
UNASSIGNED: According to the PRISMA guidelines we conducted this systematic review by searching the Cochrane, PubMed, Ovid, MedLine, and Embase databases. Inclusion criteria were the modified Coleman methodology score (mCMS) >60, age >18 years, and extra-articular fractures of the distal femur. Biomechanical and animal studies were excluded. By referring to title and abstract relevant articles were reviewed independently. In the consecutive meta-analysis, we compared 9 studies and 639 patients.
UNASSIGNED: There is no statistically significant difference comparing superficial wound infections when RIMN was performed (OR = 0.50; 95% CI: 0.18 - 1.42; P = 0.19) as well as in deep wound infections (OR = 0.74; 95% CI: 0.19-2.81; P = 0.62). However, these results were not significant. We also calculated for potential differences in the rate of non-unions depending on the surgical treatment applied. Data of 556 patients revealed an overall number of 43 non-unions. There was no significant difference in rate of non-unions between both groups (OR = 0.97; 95% CI: 0.51-1.85; P = 0.92).
UNASSIGNED: No statistical difference was found in our study among RIMN and plate fixation in the treatment of distal femoral fractures with regard to the incidence of non-union and wound infections. Therefore, the indication for RIMN or plating should be made individually and based on the surgeon\'s experience.
摘要：
■远端固定方法，股骨关节外骨折是一个有争议的讨论。为了确保自身更好的稳定性，早期动员和防止失血-所有这些都是通过扩髓髓内钉（RIMN）解决股骨的理由。多骨折的解剖复位以及不愈合的风险增加是令人信服的理由。这项研究的目的是系统地回顾不愈合和伤口感染率的文献，还有失血和手术时间.
■根据PRISMA指南，我们通过搜索Cochrane进行了系统审查，PubMed,奥维德,MedLine,和Embase数据库。纳入标准为改良Coleman方法评分（mCMS）>60，年龄>18岁，和股骨远端关节外骨折.生物力学和动物研究被排除。通过引用标题和摘要，对相关文章进行了独立审查。在连续的荟萃分析中，我们比较了9项研究和639例患者.
■进行RIMN时的浅表伤口感染（OR=0.50；95％CI：0.18-1.42；P=0.19）以及深部伤口感染（OR=0.74；95％CI：0.19-2.81；P=0.62）相比，差异无统计学意义。然而,这些结果并不显著.我们还根据所应用的手术治疗计算了不愈合率的潜在差异。556名患者的数据显示，共有43名非工会。两组间的非愈合率无显著差异(OR=0.97;95%CI:0.51-1.85;P=0.92)。
■在我们的研究中，RIMN和钢板内固定治疗股骨远端骨折在不愈合和伤口感染发生率方面没有发现统计学差异。因此,RIMN或电镀的适应症应根据外科医生的经验单独进行。
■根据PRISMA指南，我们通过搜索Cochrane进行了系统审查，PubMed,奥维德,MedLine,和Embase数据库。纳入标准为改良Coleman方法评分（mCMS）>60，年龄>18岁，和股骨远端关节外骨折.生物力学和动物研究被排除。通过引用标题和摘要，对相关文章进行了独立审查。在连续的荟萃分析中，我们比较了9项研究和639例患者.
■进行RIMN时的浅表伤口感染（OR=0.50；95％CI：0.18-1.42；P=0.19）以及深部伤口感染（OR=0.74；95％CI：0.19-2.81；P=0.62）相比，差异无统计学意义。然而,这些结果并不显著.我们还根据所应用的手术治疗计算了不愈合率的潜在差异。556名患者的数据显示，共有43名非工会。两组间的非愈合率无显著差异(OR=0.97;95%CI:0.51-1.85;P=0.92)。
■在我们的研究中，RIMN和钢板内固定治疗股骨远端骨折在不愈合和伤口感染发生率方面没有发现统计学差异。因此,RIMN或电镀的适应症应根据外科医生的经验单独进行。
