Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis

Abstract Background Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial sh...

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Main Authors: Liqing Yang, Yuefeng Sun, Ge Li
Format: Article
Language:English
Published: BMC 2018-06-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-018-0846-6
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author Liqing Yang
Yuefeng Sun
Ge Li
author_facet Liqing Yang
Yuefeng Sun
Ge Li
author_sort Liqing Yang
collection DOAJ
description Abstract Background Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Methods PubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Primary outcomes were blood loss, visual analog scale (VAS) score, range of motion, Lysholm knee scores, and fluoroscopy times. Secondary outcomes were length of hospital stay and postoperative complications. We assessed statistical heterogeneity for each outcome with the use of a standard χ 2 test and the I 2 statistic. The meta-analysis was undertaken using Stata 14.0. Results Four RCTs involving 293 participants were included in our study. The present meta-analysis indicated that there were significant differences between infrapatellar and suprapatellar intramedullary nail regarding the total blood loss, VAS scores, Lysholm knee scores, and fluoroscopy times. Conclusion Suprapatellar intramedullary nailing could significantly reduce total blood loss, postoperative knee pain, and fluoroscopy times compared to infrapatellar approach. Additionally, it was associated with an improved Lysholm knee scores. High-quality RCTs were still required for further investigation.
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spelling doaj.art-c977c54aa77d42b88a80dab20c9daeef2022-12-22T01:56:19ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-06-0113111310.1186/s13018-018-0846-6Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysisLiqing Yang0Yuefeng Sun1Ge Li2Department of orthopedics, Shengjing Hospital of China Medical UniversityDepartment of orthopedics, Shengjing Hospital of China Medical UniversityDepartment of orthopedics, Shengjing Hospital of China Medical UniversityAbstract Background Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Methods PubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Primary outcomes were blood loss, visual analog scale (VAS) score, range of motion, Lysholm knee scores, and fluoroscopy times. Secondary outcomes were length of hospital stay and postoperative complications. We assessed statistical heterogeneity for each outcome with the use of a standard χ 2 test and the I 2 statistic. The meta-analysis was undertaken using Stata 14.0. Results Four RCTs involving 293 participants were included in our study. The present meta-analysis indicated that there were significant differences between infrapatellar and suprapatellar intramedullary nail regarding the total blood loss, VAS scores, Lysholm knee scores, and fluoroscopy times. Conclusion Suprapatellar intramedullary nailing could significantly reduce total blood loss, postoperative knee pain, and fluoroscopy times compared to infrapatellar approach. Additionally, it was associated with an improved Lysholm knee scores. High-quality RCTs were still required for further investigation.http://link.springer.com/article/10.1186/s13018-018-0846-6Tibial shaft fracturesInfrapatellarSuprapatellarIntramedullary nailMeta-analysis
spellingShingle Liqing Yang
Yuefeng Sun
Ge Li
Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
Journal of Orthopaedic Surgery and Research
Tibial shaft fractures
Infrapatellar
Suprapatellar
Intramedullary nail
Meta-analysis
title Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
title_full Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
title_fullStr Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
title_full_unstemmed Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
title_short Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis
title_sort comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures a systematic review and meta analysis
topic Tibial shaft fractures
Infrapatellar
Suprapatellar
Intramedullary nail
Meta-analysis
url http://link.springer.com/article/10.1186/s13018-018-0846-6
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AT yuefengsun comparisonofsuprapatellarandinfrapatellarintramedullarynailingfortibialshaftfracturesasystematicreviewandmetaanalysis
AT geli comparisonofsuprapatellarandinfrapatellarintramedullarynailingfortibialshaftfracturesasystematicreviewandmetaanalysis