Effect of minimally invasive percutaneous plates versus interlocking intramedullary nailing in tibial shaft treatment for fractures in adults: A meta-analysis

Abstract

OBJECTIVE:The aim of this article was to determine the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults.METHOD:Literature searches of the Cochrane Library, PubMed, EMBASE, the Chinese Biomedical Literature database, the CNKI database, Wanfang Data, and the Weipu Journal database were performed up to August 2013. Only randomized and quasi-randomized controlled clinical trials comparing the use of percutaneous plates and interlocking intramedullary nails for tibial shaft fractures were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards.RESULTS:Eleven trials were included. Compared with interlocking intramedullary nailing, minimally invasive percutaneous plates shortened fracture healing time and resulted in lower rates of postoperative delayed union and pain. There was no significant difference between the two methods with regard to the rates of excellent and good Johner-Wruh scoring, the rate of reoperation, and other complications.CONCLUSIONS:Overall, insufficient evidence exists regarding the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults. Low-quality evidence suggests that minimally invasive percutaneous plates could shorten fracture healing time, decrease the rate of postoperative delayed union, and decrease pain levels compared with interlocking intramedullary nailing. There is no significant difference between the two groups in terms of functional recovery scores, reoperation, and other complications. Further research that includes high-quality randomized controlled, multicenter trials is required to compare the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults.

Short term outcome analysis of proximal tibia fractures treated with minimally invasive plate osteosynthesis

“…The time duration from injury to surgery also plays a major role in bringing the patient to early mobilization and near normal function [8,[16][17][18] . Timing of surgery when the tissues are least oedematous ensures better outcome in terms of soft tissue healing, fracture healing and early mobilization without any complications like knee stiffness [19,20] . In our study, patients operated within 5-7 days of injury came up with excellent results when compared to patients operated after one week.…”

Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

“…Other authors like Hasenboehler et al 26 have shown favorable results from the use of plates in distal tibial fractures where intramedullary nailing was contraindicated. He et al 27 reviewed 11 publications in a meta-analysis comparing the use of intramedullary nails with percutaneous plating in diaphyseal tibial fractures and found no significant differences in the outcomes between these two methods.…”

Revisión normativa y conceptual relacionada con la incapacidad medicolegal en Colombia

“…El tiempo de reparación del mismo tipo de fracturas con la utilización de diferentes tipos de material de osteosíntesis genera divergencia en la reparación. Por ejemplo, las fracturas de fémur reparadas con clavos canulados y lisos varían en promedio 6 semanas, situación que no ocurre con el uso de placas percutáneas mínimamente invasivas versus clavos intramedulares enclavados en el tratamiento de las fracturas de la diáfisis tibial en adultos [65], técnica que adicionalmente puede tener otro tipo de beneficios.…”