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Meta analysis of the effect of elastic intramedullary nail internal fixation and plate internal fixation in the treatment of ulnar and radial fractures in children |
GAO Zhuo1 WANG Yongqing2 REN Liang1 DU Bosong3 Basanta Sapkota4 |
1.Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;
2.Tianjin 4th Centre Hospital, Tianjin 300000, China;
3.Graduate School, Tianjin Medical University, Tianjin 300070, China;
4. WESTERN HOSPITAL PVT.LTD. Nepalgunj, Banke, Nepal 21900 |
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Abstract Objective To systematically evaluate the effect of elastic intramedullary nail internal fixation and plate internal fixation on the treatment of ulnar and radial double fractures in children. Methods A computer search was conducted on the relevant literatures of CNKI, VIP, WanFang and PubMed, EMBase and Cochrane Library. The retrieval period was from the establishment of the database to September 2019. RevMan5.3 software was used to analyze and compare the total effective rate, operation time, hospital stay, adverse reactions, intraoperative blood loss and incision length of elastic intramedullary nail internal fixation and plate internal fixation on the treatment of ulnar and radial double fractures in children. Results A total of 8 literatures were included in the study, all of which were randomized controlled trials with a total of 650 patients (325 in the elastic intramedullary nail internal fixation group and 325 in the plate internal fixation group). The differences of the total effective rate [OR = 3.80,95%CI(2.07,6.96),P < 0.0001], operation time [MD = -29.13,95%CI(-34.03, -24.24),P < 0.000 01], hospital stay [MD = -8.70,95%CI(-13.00, -4.41),P < 0.0001], intraoperative blood loss [MD = -83.62,95%CI(-162.81, -4.43),P = 0.04] and incision length [MD = -8.72,95%CI(-10.94, -6.51),P < 0.000 01] between the two groups were statistically significant. The elastic intramedullary nail internal fixation group was superior to the plate internal fixation group. There was no significant difference in postoperative adverse reactions between the two groups [OR = 0.69, 95%CI (0.26, 1.84), P = 0.46]. Conclusion In the treatment of children with ulnar and radial double fractures, elastic intramedullary nail internal fixation has the advantages of short operation time, small incision length, less intraoperative blood loss and high total effective rate compared with plate internal fixation, and does not increase the incidence of postoperative adverse reactions. Due to the limited number and quality of included literatures, the above conclusions need to be verified by more studies of higher quality.
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