Comparison of Elastic Nailing and Plate-Screw Fixation for Pediatric Femoral Shaft Fractures: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials - Summary - MDSpire
Advertisement
Comparison of Elastic Nailing and Plate-Screw Fixation for Pediatric Femoral Shaft Fractures: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials
To compare elastic stable intramedullary nailing (ESIN) and plate fixation in children under 18 years with femoral shaft fractures, evaluating surgical, radiographic, and functional outcomes, including complication rates.
Key Findings:
ESIN significantly reduced operative time (MD −36.76 min, P = 0.03) and blood loss (MD −94.77 mL, P < 0.00001) compared to plating, which may influence recovery times.
No significant differences in fracture union (MD −1.30 weeks, P = 0.16) or hospital stay (MD −3.80 days, P = 0.18), indicating similar effectiveness in healing.
ESIN was associated with implant-related irritation, while plating had higher risks of deep infection and postoperative stiffness, highlighting different complication profiles.
Interpretation:
ESIN offers advantages in terms of shorter operative time and reduced blood loss, but presents different complication profiles compared to plating, necessitating careful consideration of each method's risks.
Limitations:
The study included only six RCTs with a total of 364 children, which may limit the generalizability of the findings and introduce potential biases.
Further multicenter RCTs with extended follow-up are needed for more definitive guidance.
Conclusion:
ESIN is preferable for its operational efficiency, but the choice between ESIN and plating should consider the specific complications associated with each method and be tailored to individual patient needs.
by Majed N. Alosaimi, Rayan H. Abuhadi, Khaled M. Qanash, Saleh G. Alqadi, Abdullah B. Alsharif, Shoq F. Alghamdi, Jana Y. Aljohani, Lujain K. Anbari, Ahmed H. Kaneetah, Saeed I. Alqahtani
