Comparison of Intramedullary Nailing versus Plating Fixation in the Treatment of Adult Diaphyseal Both-Bone Forearm
MIAO Jie-jia1, 3, LUO Yi2, ZHOU Huo-long3, ZHENG Fu-qi3, CHEN Guo-tao3, BAO Hang-sheng3, LIU Yong-yu3, ZHENG Yang-kang1, 3, LI Yi-qun1, 4
1. Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Guangdong Province Foshan 528000, China; 2. Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangdong Province Guangzhou 510405, China; 3. Foshan Hospital of Traditional Chinese Medicine, Guangdong Province Foshan 528000, China; 4. Foshan Second People's Hospital, Guangdong Province Foshan 528000, China
Abstract：Objective: The purpose of this meta-analysis is to determine whether plating or intramedullary nailing (IMN) for adult diaphyseal both-bone forearm fractures (BBFF) provides better clinical outcomes. Methods: MEDLINE, EMBASE, Google Scholar and The Cochrane Library were comprehensively searched until July 31, 2016. Both retrospective study and prospective trails about comparison of dual IMN or hybrid fixation versus dual plating fixation in the treatment of adult diaphyseal BBFF were included. Using RevMan5.3 software, data of functional recovery, the union time, operating time and complication was extracted for meta-analysis. Results: The pooled analysis showed similar results in the union time, functional recovery and the rates of complications, but showed a significant difference in operating time. Conclusion: This meta-analysis demonstrates similar radiographic outcomes, functional outcomes and complications with plates or IMN used in the treatment of adult diaphyseal BBFF. IMN fixation for these fractures seems to be an alternative and effective treatment with shorter operating times and minimally invasive.
. [J]. 中国生物医学工程学报(英文版）, 2017, 26(4): 158-171.
MIAO Jie-jia, LUO Yi, ZHOU Huo-long, ZHENG Fu-qi, CHEN Guo-tao, BAO Hang-sheng, LIU Yong-yu, ZHENG Yang-kang, LI Yi-qun. Comparison of Intramedullary Nailing versus Plating Fixation in the Treatment of Adult Diaphyseal Both-Bone Forearm. Chinese Journal of Biomedical Engineering, 2017, 26(4): 158-171.
[1] Rennie L, Court-Brown C, Mok J, et al. The epidemiology of fractures in children[J]. Injury, 2007, 38(8): 913-922. [2] Bartoníek J, Kozánek M, Jupiter JB. History of operative treatment of forearm diaphyseal fractures[J]. Journal of Hand Surgeny-American Volume, 2014, 39(2): 335-342. [3] Matthews LS, Kaufer H, Garver DF, et al. The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm[J]. Journal of Bone and Joint Surgery, 1982, 64A:14-17. [4] Schemitsch EH, Richards RR. The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults[J]. Journal of Bone and Joint Surgery, 1992, 74A:1068-1078. [5] Bot AG, Doornberg JN, Lindenhovius AL, et al. Long term outcomes of fractures of both bones of the forearm[J]. Journal of Bone and Joint Surgery, 2011, 93(6): 527-532. [6] Prasarn ML, Ouellette EA, Miller DR. Infected nonunions of diaphyseal fractures of the forearm[J]. Archives of Orthopaedic and Trauma Surgery, 2010, 130(7): 867-873. [7] Rosson JW, Egan J, Shearer JR, et al. Bone weakness after the removal of plates and screws—cortical atrophy or screw holes[J]. Journal of Bone and Joint Surgery, 1991, 2: 283-286. [8] Dumont CE, Thalmann R, Macy JC. The effect of rotational malunion of the radius and the ulna on supination and pronation[J]. Journal of Bone and Joint Surgery, 2002, 84B: 1070-1074. [9] Bednar DA, Grandwilewski W. Complications of forearm-plate removal[J]. Canadian Journal of Surgery, 1992, 35: 428-431. [10] Labosky DA, Cermak MB, Waggy CA. Forearm fracture plates: to remove or not to remove[J]. Journal Hand Surgery, 1990, 15A: 294-301. [11] Rosson JW, Shearer JR. Refracture after the removal of plates from the forearm: An avoidable complication[J]. Journal of Bone and Joint Surgery, 1991, 73B: 415-417. [12] Rumball K, Finnegan M. Refractures after forearm plate removal[J]. Journal of Orthopaedic Trauma, 1990, 4:124-129. [13] Rand JA, An KN, Chao EY, et al. A comparison of the effect of open intramedullary nailing and compression-plate fixation on fracture-site blood flow and fracture union[J]. Journal of Bone and Joint Surgery, 1981, 63A: 427-442. [14] Visna P, Beitl E, Pilny J, et al. Interlocking nailing of forearm fractures[J]. Acta Chirurgica Belgice, 2008, 108: 333-338. [15] Weckbach A, Blattert TR, Weisser C. Interlocking nailing of forearm fractures. Archives of Orthopaedic and Trauma Surgery, 2006, 126(5):309-315. [16] Dymond IW. The treatment of isolated fractures of the distal ulna[J]. Journal of Bone and Joint Surgery, 1984, 66: 408-410 [17] Baldwin K, Morrison MJ, Tomlinson LA, et al. Both bone forearm fractures in children and adolescents, which fixation strategy is superior - plates or nails? A systematic review and meta-analysis of observational studies[J]. Journal of Orthopaedic Trauma, 12014, 28(1): e8-e14. [18] Patel A, Li L, Anand A. Systematic review: functional outcomes and complications of intramedullary nailing versus plate fixation for both-bone diaphyseal forearm fractures in children[J]. Injury, 2014, 45(8): 1135-1143. [19] Truntzer J, Vopat ML, Kane PM, et al. Forearm diaphyseal fractures in the adolescent population: treatment and management[J]. European Journal of Orthopaedic Surgery & Traumatology, 2015, 25(2): 201-209. [20] Grace TG, Eversmann WW Jr. Forearm fractures: treatment by rigid fixation with early motion[J]. Journal of Bone and Joint Surgery, 1980, 62: 433-438. [21] Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand): the Upper Extremity Collaborative Group (UECG)[J]. American Journal of Industrial Medicine, 1996, 29(6): 602-608. [22] Behnke MK, Redjal R, Nguyen T, et al. Internal fixation of diaphyseal fractures of the forearm: A retrospective comparison of hybrid fixation versus dual plating[J]. Journal of Orthopaedic Trauma, 2012, 26: 611-616. [23] Ozkaya U, Kilic A, Ozdogan U, et al. Comparison between locked intramedullary nailing and plate osteosynthesis in the management of adult forearm fractures[J]. Acta Orthop Traumatol Turc, 2009, 43(1):14-20. [24] Lee SK, Kim KJ, Lee JW, et al. Plate osteosynthesis versus intramedullary nailing for both forearm bones fractures[J]. European Journal of Orthopaedic Surgery & Traumatology, 2014, 24: 769-776. [25] Zhang XF, Huang JW, Mao HX, et al. Adult diaphyseal both-bone forearm fractures: A clinical and biomechanical comparison of four different fixations[J]. Orthopaedics & Traumatology: Surgery & Research, 2016, 102: 319-325. [26] Kim SB, Heo YM, Yi JW, et al. Shaft fractures of both forearm bones: the outcomes of surgical treatment with plating only and combined plating and intramedullary nailing[J]. Clinics in Orthopedic Surgery, 2015, 7: 282-290. [27] Sutton AJ, Duval SJ, Tweedie RL, et al. Empirical assessment of effect of publication bias on meta-analyses[J]. BMJ, 2000, 320: 1574-1577. [28] Langkamer VG, Ackroyd CE. Internal fixation of the forearm fractures in the 1980s: lessons to be learnt[J]. Injury, 1991, 22:97-102. [29] Street DM. Intramedullary forearm nailing[J]. Clinical Orthopaedics and Related Research, 1986, 212: 219-230. [30] Marek FM. Axial fixation of forearm fractures[J]. Journal of Bone and Joint Surgery, 1961, 8: 1099-1114. [31] Lee YH, Lee SK, Chung MS, et al. Interlocking contoured intramedullary nail fixation for selected diaphyseal fractures of the forearm in adults[J]. Journal of Bone and Joint Surgery, 2008, 9: 1891-1898. [32] Gao H, Luo CF, Zhang CQ, et al. Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail: Shortterm results in eighteen patients[J]. Journal of Orthopaedic Trauma, 2005, 19(6): 384-391. [33] Hong GC, Cong-Feng L, Hui-Peng S, et al. Treatment of diaphyseal forearm nonunions with interlocking intramedullary nails[J]. Clinical Orthopaedics and Related Research, 2006, 450: 186-192. [34] Jones DB, Kakar S. Adult diaphyseal forearm fractures: Intramedullary nail versus plate fixation[J]. Journal of Hand Surgeny-American Volume, 2011, 36(7): 1216-1219. [35] Jupiter J, Kellam J. Diaphyseal fractures of the forearm[M]. Jupiter J, Browner B. Skeletal Trauma. 4th ed. Philadelphia, PA: Saunders Eslevier, 2008, 1459-1502. [36] Tarr RR, Garfinkel AI, Sarmiento A. The effects of angular and rotational deformities of both bones of the forearm. An in-vitro study[J]. Journal of Bone and Joint Surgery, 1984, 1: 65-70. [37] Anderson LD, Sisk D, Tooms RE, et al. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna[J]. Journal of Bone and Joint Surgery, 1975, 57(3): 287-297. [38] Chapman MW, Gordon JE, Zissimos AG. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna[J]. Journal of Bone and Joint Surgery, 1989, 71(2): 159-169. [39] Catalano LW III, Zlotolow DA, Hitchcock PB, et al. Surgical exposures of the radius and ulna[J]. Journal American Acadeny of Orthopeadic Surgeons, 2011, 19(7): 430-438. [40] Brumback RJ, Virkus WW. Intramedullary nailing of the femur: reamed versus nonreamed[J]. Journal American Acadeny of Orthopeadic Surgeons, 2000, 8: 83-90. [41] Stannard JP, Harris HW, McGwin Jr G, et al. Intramedullary nailing of humeral shaft fractures with a locking flexible nail[J]. Journal of Bone and Joint Surgery, 2003, 85: 2103-2110. [42] Rehman S, Sokunbi G. Intramedullary fixation of forearm fractures[J]. Hand Clinics, 2010, 26(3): 391-401. [43] Saka G, Saglam N, Kurtulmus T, et al. New interlocking intramedullary radius and ulna nails for treating forearm diaphyseal fractures in adults: a retrospective study[J]. Injury, 2014, 45S: S16-S23. [44] Kǒse A, Aydn A, Ezirmik N, et al. Alternative treatment of forearm double fractures: new design intramedullarynail[J]. Archives of Orthopaedic and Trauma Surgery, 2014, 134:1387-1396.
