■股骨干骨折是临床实践中最常见的骨折之一。许多手术和非手术的选择很容易用于治疗这种骨折,髓内钉是金标准。迄今为止,没有达成共识,赞成一种方法。因此,本荟萃分析旨在比较顺行和逆行髓内钉治疗股骨干骨折的结局.
■PubMed,科克伦,谷歌学者(第1-20页),和Embase被搜索到2024年1月。评估的临床结果是不良事件的发生率,重新操作,臀部和膝盖疼痛,和手术相关参数。
■髋部疼痛发生率较高,顺行钉法观察到异位骨化(分别为p=0.0003和p=0.0002)。然而,在逆行钉扎术中,膝关节疼痛的发生率更高(p=0.02)。其余分析结果如手术时间无统计学差异,再手术率或其他并发症。
■尽管使用顺行钉技术的异位骨化率较高,顺行和逆行钉钉技术的总体结果相似.因此,选择一个或另一个的决定应该基于患者相关因素,以及外科医生的经验和偏好。
UNASSIGNED: Femoral shaft fractures are one of the most prevalent fractures found in clinical practice. Numerous operative and non-operative options are readily available for the treatment of such fractures with intra-medullary nailing being the gold standard. To date, no consensus has been reached favoring one approach over the other. Thus, this meta-analysis aims to compare the outcomes between an antegrade and
retrograde intra-medullary nailing for the treatment of femoral shaft fractures.
UNASSIGNED: PubMed, Cochrane, Google Scholar (page 1-20), and Embase were searched till January 2024. The clinical outcomes evaluated were the incidence of adverse events, reoperations, hip and knee pain, and surgery-related parameters.
UNASSIGNED: Higher rates of hip pain, and heterotopic ossification (p=0.0003, and p=0.0002 respectively) was observed with antegrade nailing. However, a higher rate of knee pain (p=0.02) was appreciated in
retrograde nailing. There was no statistically significant difference in the remaining analyzed outcomes such as operative time, reoperation rate or other complications.
UNASSIGNED: Despite a higher rate of heterotopic ossification using the antegrade nailing technique, both the antegrade and
retrograde nailing techniques yield overall similar outcomes. Therefore, the decision to choose one or the other should be based on patient-related factors, and the surgeon\'s experience and preference.