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Minerva Ortopedica e Traumatologica 2014 December;65(6):385-93


lingua: Inglese

Meta-analysis of outcomes of interlocking intramedullary nailing in different directions for femoral shaft fractures

Wang J. 1, Xing D. 2, Ma J. X. 1, Yang Y. 1, Zhu S. W. 1, Ma B. Y. 1, Chen Y. 1, Feng R. 2, Jia H. B. 2, Yu J. T. 2, Ma X. L. 1, 2

1 Biomechanics Labs of the Orthopedics Institute, Tianjin Hospital, Hexi District, Tianjin, China; 2 Biomechanical Lab of the Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China


Antegrade intramedullary nail was the common treatment for the femoral shaft fractures. But in the past ten years, retrograde interlocking nail have been used more and more often. And the prognosis of retrograde and antegrade nail for the treatment of the femoral shaft fractures is still a controversy. Our meta-analysis was to evaluate outcomes of retrograde versus antegrade interlocking intramedullary nailing for femoral shaft fractures. Prospective and retrospective cohort studies were identified from computer databases. We extracted data on study characteristics, participant’s characteristics, therapeutic interventions, and so on. And we used the MINORS list to assess the methodological quality and risk of bias. RevMan 5.1.1 software was used for data analysis. Five prospective cohort studies and two retrospective cohort studies were included. The combined results of meta-analysis showed that there were statistically significant differences in the incidence of the hip pain, incidence of the knee pain and complication rate of the distal screws between the two groups. However, when came to the union rate, nonunion rate and operation time, there were no statistically significant differences between the two groups. There was no robust evidence that favour either direction of interlocking intramedullary nailing for femoral shaft fractures.

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