Abstract:
BACKGROUND:There is currently a debate about whether elastic stable intramedullary nails (ESIN) or external fixation (EF) is the best surgical method for treating pediatric femoral shaft fractures. We performed a meta-analysis to determine which surgical method leads to higher treatment satisfaction, lower complication rates, and reduced treatment time, to investigate whether ESIN is the preferred surgical method for treatment of pediatric femoral shaft fractures. PATIENTS AND METHODS:Relevant databases were searched for comparative studies of ESIN versus EF for the treating pediatric femoral shaft fractures. Literature reports and quality evaluations were extracted, followed by a systematic review using RevMan 5.3 software. Treatment satisfaction at the last follow-up, primary complications, secondary complications, and relevant time indicators (operation time, hospital stay, clinical healing time, bone healing time) were analyzed. RESULTS:A total of 22 reports were included in this meta-analysis. We found no statistical differences in the treatment satisfaction at the last follow-up between ESIN and EF for the treatment of pediatric femoral shaft fractures. A low rate of postoperative re-fracture (RR=3.58, 95% CI (1.85, 6.92), p=0.0001) and postoperative infection (RR=9.25, 95% CI (5.32, 16.11), p<0.00001), and a high risk of skin irritation (RR=0.15, 95% CI (0.06, 0.37), p<0.00001) were found in the ESIN group. No significant differences between the two approaches were found regarding malunion. A low rate of limb-length discrepancy (RR=2.41, 95% CI (1.40, 4.17), p=0.002), hospitalization (SMD=0.84, 95% CI (0.24, 1.43), p=0.006), clinical healing time (SMD=0.95, 95% CI (0.56, 1.33), p<0.00001) and bone healing time (SMD=0.89, 95% CI (0.39, 1.40), p=0.005) were found in the ESIN group, as compared to that in the EF group. No significant differences were found in fixation failure, activity limitation of the joint, and operation time between the two strategies. DISCUSSION:ESIN should be the primary choice for the treatment of pediatric femoral shaft fractures since it has a reliable curative effect and results in a shorter hospital stay, faster fracture healing, and fewer complications. EF is recommended for fractures with serious injury of the soft tissue to avoid intramedullary infection. Double-blind high-quality randomized studies with larger sample sizes are warranted to confirm our conclusions. LEVEL OF EVIDENCE:IV.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Chen X,Lu M,Xu W,Wang X,Xue M,Dai J,Zhang Z,Chen Gdoi
10.1016/j.otsr.2020.06.012subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1305-1311issue
7issn
1877-0568pii
S1877-0568(20)30255-3journal_volume
106pub_type
杂志文章abstract:BACKGROUND:There are several clinical outcome scores relating to meniscal injuries reported in the literature. However, the result of one scoring system is often different from that of the others even when assessing the same group of patients. This makes the comparison of results of studies who have used different outc...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2021.102803
更新日期:2021-01-09 00:00:00
abstract:INTRODUCTION:Physicians, whether in the public or private sector, are increasingly bound to "publish or perish". Although researchers have become aware of certain ethical concerns relating to the concept of authorship, clinicians still tend to neglect issues of copyright. The present study aims: 1) to explain to orthop...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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doi:10.1016/j.otsr.2011.11.004
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.07.010
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.11.025
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.03.020
更新日期:2011-09-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.03.025
更新日期:2011-10-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.11.011
更新日期:2018-02-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.10.019
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
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更新日期:2020-10-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
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更新日期:2020-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.otsr.2018.01.018
更新日期:2018-06-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.08.010
更新日期:2019-11-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.09.019
更新日期:2014-12-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
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更新日期:2017-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.05.014
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of i...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.rcot.2010.02.005
更新日期:2010-04-01 00:00:00
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journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.01.018
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Osteotomy is a rational approach to slowing knee osteoarthritis progression by modifying loads, thereby avoiding joint replacement in younger individuals. Varus femoral osteotomy is recommended only in patients with more than 10° of valgus. The objective here was to assess outcomes of tibial varus osteotomy ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.03.020
更新日期:2017-10-01 00:00:00