未经授权:股骨远端骨折的手术治疗随着时间的推移而发展,这取决于某些因素;开放性或闭合性骨折类型,断裂的模式,干phy端粉碎的存在,关节内伸展,骨骼质量是关键的。逆行髓内钉(RIMN)和锁定钢板(LP)均可用于固定这些骨折。然而,两种设备之间的最佳方法仍然是一个争论的话题,一个比另一个的优越性是不清楚的。因此,本系统综述和荟萃分析旨在比较RIMN与股骨远端LP的结局.
UNASSIGNED:主要的电子搜索是在Medline(PubMed)上进行的,Scopus,Embase,Cinahl,和Cochrane图书馆数据库,用于从开始到2022年2月25日的已出版文献。这些研究比较了RIMN与LP固定治疗急性髁上或股骨远端骨折(AO/OTA型33A,B,和C)并报告至少一次(平均骨折愈合时间,并发症,植入物相关并发症,和再次手术率)或次要结果(手术持续时间,术中失血,和膝盖运动范围),包括在内。
未经评估:六项随机对照试验,纳入2项前瞻性研究和8项回顾性研究,共936例患者,其中8例双侧病例(467:RIMN;477:LP)。我们的分析表明,平均骨折愈合时间没有统计学上的显著差异,整体并发症,植入物相关并发症,再手术率,和手术时间。尽管在LP组中看到了更好的膝盖运动范围,然而,与RIMN组相比,它还显示了更多的骨不连和感染。
UNASSIGNED:本综述显示,骨不连和感染明显减少,在RIMN组中,与股骨远端骨折的LP相比,尽管在后者中看到了更好的术后膝关节活动范围。然而,就骨折愈合时间而言,并发症的总发生率,再手术率,和手术的持续时间,两种手术选择没有区别。
UNASSIGNED: The surgical treatment for distal femur fractures has evolved over time, and it depends upon certain factors; open or closed fracture type, the pattern of fracture, presence of metaphyseal comminution, intra-articular extension, and the bone quality are some of the crucial ones. Both retrograde intramedullary nails (RIMN) and locking plates (LP) can be used for the fixation of these fractures. However, the optimal method among the two devices is still a topic of debate, the superiority of one over the other being unclear. Hence, this systematic
review and meta-analysis was conceptualized to compare the outcomes of RIMN with distal femur LP.
UNASSIGNED: The primary electronic search was conducted on Medline (PubMed), Scopus, Embase, Cinahl, and Cochrane Library databases for the published literature from the inception to 25th February 2022. The studies compared outcomes of RIMN versus LP fixation of the acute supracondylar or distal femur fracture (AO/OTA type-33A, B, and C) and reported at least one primary (mean fracture union time, complications, implant-related complications, and re-operation rate) or secondary outcome (duration of surgery, intra-operative blood loss, and knee range of motion), were included.
UNASSIGNED: Six randomized control trials, 2 prospective and 8 retrospective studies with 936 patients with 8 bilateral cases (467: RIMN; 477: LP) were included. Our analysis demonstrated no statistically significant difference in terms of mean fracture union time, overall complications, implant-related complications, re-operation rates, and duration of surgeries. Although a better knee range of motion was seen in the LP group, however, it also showed more nonunion and infection than the RIMN group.
UNASSIGNED: The present
review shows that there are significantly lesser nonunions and infections, in the RIMN group as compared to LP for distal femur fractures, although a better postoperative knee range of motion was seen in the latter. However, in terms of fracture union time, the overall rate of complications, re-operation rates, and duration of surgeries, there is no difference between the two surgical options.