Efficacy of retrograde intramedullary femoral nailing and locking plates in the treatment of distal femoral fracture: a systematic review and meta analysis
DOI: 10.54647/cm32883 98 Downloads 3790 Views
Author(s)
Abstract
The preferred treatment for distal femoral fracture was surgical reduction and internal fixation. In recent years, retrograde intramedullary nails(RIN) and locking plates were the most popular internal fixation methods in clinical practice. The goal of this study was to review eligible studies and compare the efficacy of retrograde intramedullary femoral nailing (RIN) and locking plates for the treatment of distal femoral fracture. A systematic search of electronic databases (PubMed, Cochrane Library and Embase) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline with no language limitation. Studies were included if they compared the results of retrograde intramedullary femoral nailing (RIN) and locking plates for distal femoral fracture in adults. Data on the study setting, blood loss, operative time, non-union, varus or valgus deformity>5°, the excellent and good rate of knee society function score criteria. A quality assessment was performed using the Quality Index score. We included 10 studies, with a total of 240 patients in the RIN group and 230 in the locking plates group. The results found that after RIN and locking plates, no significant difference in changes of blood loss (MD: -69.55, 95% CI: − 265.98–126.89), operative time (MD: -30.23, 95% CI: − 70.97–10.51), non-union (OR: 0.99, 95% CI: 0.37–2.66), varus or valgus deformity>5° (OR: 2.10, 95% CI: 0.93–4.74), the excellent and good rate of knee society function score criteria (OR: 1.41, 95% CI: 0.81–2.46). There was no significant difference in clinical efficacy between RIN and locking plates in treating distal femoral fracture. RIN has obvious biomechanical advantages over locking plates, but, the locking plate is better choice for the treatment of osteoporotic distal femoral fractures in the elderly. According to patient's age, bone condition, fracture types, surgeons should make individual treatment plans.
Keywords
Retrograde intramedullary femoral nail· Plate· Internal fixation· Distal femoral fracture · Meta-analysis
Cite this paper
Zhen Yang, Wei Zhang, Peng Fu, Xianfeng Meng,
Efficacy of retrograde intramedullary femoral nailing and locking plates in the treatment of distal femoral fracture: a systematic review and meta analysis
, SCIREA Journal of Clinical Medicine.
Volume 7, Issue 4, August 2022 | PP. 267-282.
10.54647/cm32883
References
[ 1 ] | Court-Brown CM, Caesar B: Epidemiology of adult fractures: A review. Injury 37:691-7, 2006 |
[ 2 ] | Thomson AB, Driver R, Kregor PJ, et al: Long-term functional outcomes after intra-articular distal femur fractures: ORIF versus retrograde intramedullary nailing. Orthopedics 31:748-50, 2008 |
[ 3 ] | Chrisovitsinos JP, Xenakis T, Papakostides KG, et al: Bridge plating osteosynthesis of 20 comminuted fractures of the femur. Acta Orthop Scand Suppl 275:72-6, 1997 |
[ 4 ] | Christodoulou A, Terzidis I, Ploumis A, et al: Supracondylar femoral fractures in elderly patients treated with the dynamic condylar screw and the retrograde intramedullary nail: A comparative study of the two methods. Archives of Orthopaedic and Trauma Surgery 125:73-79, 2005 |
[ 5 ] | Hartin NL, Harris I, Hazratwala K: Retrograde nailing versus fixed-angle blade plating for supracondylar femoral fractures: a randomized controlled trial. ANZ J Surg 76:290-4, 2006 |
[ 6 ] | Dar GN, Tak SR, Kangoo KA, et al: Bridge plate osteosynthesis using dynamic condylar screw (DCS) or retrograde intramedullary supracondylar nail (RIMSN) in the treatment of distal femoral fractures: comparison of two methods in a prospective randomized study. Ulus Travma Acil Cerrahi Derg 15:148-53, 2009 |
[ 7 ] | Griffin XL, Costa ML, Phelps E, et al: Intramedullary nails versus distal locking plates for fracture of the distal femur: results from the Trial of Acute Femoral Fracture Fixation (TrAFFix) randomised feasibility study and process evaluation. BMJ Open 9:e026810, 2019 |
[ 8 ] | Henderson CE, Lujan T, Bottlang M, et al: Stabilization of distal femur fractures with intramedullary nails and locking plates: differences in callus formation. Iowa Orthop J 30:61-8, 2010 |
[ 9 ] | Mukherjee P, Bovell C, Davis J: Less invasive stabilising system plate versus retrograde intramedullary nail for osteoporotic distal femoral fracture. European Journal of Orthopaedic Surgery and Traumatology 20:281-284, 2010 |
[ 10 ] | Niyazi M, Wumair A, Maimaiti M, et al: Comparison of retrograde intramedullary nail and plate implantation for internal fixation for the treatment of distal femur fractures. Chinese Journal of Tissue Engineering Research 16:8201-8205, 2012 |
[ 11 ] | Gao K, Gao W, Huang J, et al: Retrograde nailing versus locked plating of extra-articular distal femoral fractures: comparison of 36 cases. Med Princ Pract 22:161-6, 2013 |
[ 12 ] | Demirtaş A, Azboy I, Özkul E, et al: Comparison of retrograde intramedullary nailing and bridge plating in the treatment of extra-articular fractures of the distal femur. Acta Orthop Traumatol Turc 48:521-6, 2014 |
[ 13 ] | Yang KH, Yang J, Yang GZ: Comparison of the stability of three internal fixators for distal femoral fracture. Chinese Journal of Tissue Engineering Research 18:565-570, 2014 |
[ 14 ] | Henry SL: Supracondylar femur fractures treated percutaneously. Clin Orthop Relat Res:51-9, 2000 |
[ 15 ] | Handolin L, Pajarinen J, Lindahl J, et al: Retrograde intramedullary nailing in distal femoral fractures--results in a series of 46 consecutive operations. Injury 35:517-22, 2004 |
[ 16 ] | Schatzker J, Mahomed N, Schiffman K, et al: Dynamic condylar screw: a new device. A preliminary report. J Orthop Trauma 3:124-32, 1989 |
[ 17 ] | Moore TJ, Watson T, Green SA, et al: Complications of surgically treated supracondylar fractures of the femur. J Trauma 27:402-6, 1987 |
[ 18 ] | Huang HT, Huang PJ, Su JY, et al: Indirect reduction and bridge plating of supracondylar fractures of the femur. Injury 34:135-40, 2003 |
[ 19 ] | Saw A, Lau CP: Supracondylar nailing for difficult distal femur fractures. J Orthop Surg (Hong Kong) 11:141-7, 2003 |
[ 20 ] | Seifert J, Stengel D, Matthes G, et al: Retrograde fixation of distal femoral fractures: results using a new nail system. J Orthop Trauma 17:488-95, 2003 |
[ 21 ] | Johnson EE, Marroquin CE, Kossovsky N: Synovial metallosis resulting from intraarticular intramedullary nailing of a distal femoral nonunion. J Orthop Trauma 7:320-4; discussion 325-6, 1993 |
[ 22 ] | Ostrum RF, Maurer JP: Distal third femur fractures treated with retrograde femoral nailing and blocking screws. J Orthop Trauma 23:681-4, 2009 |
[ 23 ] | Anakwe RE, Aitken SA, Khan LA: Osteoporotic periprosthetic fractures of the femur in elderly patients: outcome after fixation with the LISS plate. Injury 39:1191-7, 2008 |
[ 24 ] | Ito K, Grass R, Zwipp H: Internal fixation of supracondylar femoral fractures: comparative biomechanical performance of the 95-degree blade plate and two retrograde nails. J Orthop Trauma 12:259-66, 1998 |
[ 25 ] | Firoozbakhsh K, Behzadi K, DeCoster TA, et al: Mechanics of retrograde nail versus plate fixation for supracondylar femur fractures. J Orthop Trauma 9:152-7, 1995 |
[ 26 ] | Kiyono M, Noda T, Nagano H, et al: Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort. J Orthop Surg Res 14:384, 2019 |