Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis

Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Salman, Loay A. [verfasserIn] Al-Ani, Abdallah Radi, Mohammed F. A. Abudalou, Abedallah F. Baroudi, Omar M. Ajaj, Abdulla A. Alkhayarin, Mohamed Ahmed, Ghalib

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Open reduction Closed reduction Intramedullary nail Femur Fractures

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: International orthopaedics - Berlin : Springer, 1977, 47(2023), 12 vom: 03. März, Seite 3031-3041
Übergeordnetes Werk:	volume:47 ; year:2023 ; number:12 ; day:03 ; month:03 ; pages:3031-3041

Links:	Volltext

DOI / URN:	10.1007/s00264-023-05740-x

Katalog-ID:	SPR053844521

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245	1	0	\|a Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
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520			\|a Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies.
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allfields	10.1007/s00264-023-05740-x doi (DE-627)SPR053844521 (SPR)s00264-023-05740-x-e DE-627 ger DE-627 rakwb eng Salman, Loay A. verfasserin aut Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213 Al-Ani, Abdallah aut Radi, Mohammed F. A. aut Abudalou, Abedallah F. aut Baroudi, Omar M. aut Ajaj, Abdulla A. aut Alkhayarin, Mohamed aut Ahmed, Ghalib (orcid)0000-0003-4326-7250 aut Enthalten in International orthopaedics Berlin : Springer, 1977 47(2023), 12 vom: 03. März, Seite 3031-3041 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041 https://dx.doi.org/10.1007/s00264-023-05740-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 47 2023 12 03 03 3031-3041
spelling	10.1007/s00264-023-05740-x doi (DE-627)SPR053844521 (SPR)s00264-023-05740-x-e DE-627 ger DE-627 rakwb eng Salman, Loay A. verfasserin aut Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213 Al-Ani, Abdallah aut Radi, Mohammed F. A. aut Abudalou, Abedallah F. aut Baroudi, Omar M. aut Ajaj, Abdulla A. aut Alkhayarin, Mohamed aut Ahmed, Ghalib (orcid)0000-0003-4326-7250 aut Enthalten in International orthopaedics Berlin : Springer, 1977 47(2023), 12 vom: 03. März, Seite 3031-3041 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041 https://dx.doi.org/10.1007/s00264-023-05740-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 47 2023 12 03 03 3031-3041
allfields_unstemmed	10.1007/s00264-023-05740-x doi (DE-627)SPR053844521 (SPR)s00264-023-05740-x-e DE-627 ger DE-627 rakwb eng Salman, Loay A. verfasserin aut Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213 Al-Ani, Abdallah aut Radi, Mohammed F. A. aut Abudalou, Abedallah F. aut Baroudi, Omar M. aut Ajaj, Abdulla A. aut Alkhayarin, Mohamed aut Ahmed, Ghalib (orcid)0000-0003-4326-7250 aut Enthalten in International orthopaedics Berlin : Springer, 1977 47(2023), 12 vom: 03. März, Seite 3031-3041 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041 https://dx.doi.org/10.1007/s00264-023-05740-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 47 2023 12 03 03 3031-3041
allfieldsGer	10.1007/s00264-023-05740-x doi (DE-627)SPR053844521 (SPR)s00264-023-05740-x-e DE-627 ger DE-627 rakwb eng Salman, Loay A. verfasserin aut Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213 Al-Ani, Abdallah aut Radi, Mohammed F. A. aut Abudalou, Abedallah F. aut Baroudi, Omar M. aut Ajaj, Abdulla A. aut Alkhayarin, Mohamed aut Ahmed, Ghalib (orcid)0000-0003-4326-7250 aut Enthalten in International orthopaedics Berlin : Springer, 1977 47(2023), 12 vom: 03. März, Seite 3031-3041 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041 https://dx.doi.org/10.1007/s00264-023-05740-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 47 2023 12 03 03 3031-3041
allfieldsSound	10.1007/s00264-023-05740-x doi (DE-627)SPR053844521 (SPR)s00264-023-05740-x-e DE-627 ger DE-627 rakwb eng Salman, Loay A. verfasserin aut Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213 Al-Ani, Abdallah aut Radi, Mohammed F. A. aut Abudalou, Abedallah F. aut Baroudi, Omar M. aut Ajaj, Abdulla A. aut Alkhayarin, Mohamed aut Ahmed, Ghalib (orcid)0000-0003-4326-7250 aut Enthalten in International orthopaedics Berlin : Springer, 1977 47(2023), 12 vom: 03. März, Seite 3031-3041 (DE-627)253724376 (DE-600)1459230-7 1432-5195 nnns volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041 https://dx.doi.org/10.1007/s00264-023-05740-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 47 2023 12 03 03 3031-3041
language	English
source	Enthalten in International orthopaedics 47(2023), 12 vom: 03. März, Seite 3031-3041 volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041
sourceStr	Enthalten in International orthopaedics 47(2023), 12 vom: 03. März, Seite 3031-3041 volume:47 year:2023 number:12 day:03 month:03 pages:3031-3041
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Open reduction Closed reduction Intramedullary nail Femur Fractures
isfreeaccess_bool	true
container_title	International orthopaedics
authorswithroles_txt_mv	Salman, Loay A. @@aut@@ Al-Ani, Abdallah @@aut@@ Radi, Mohammed F. A. @@aut@@ Abudalou, Abedallah F. @@aut@@ Baroudi, Omar M. @@aut@@ Ajaj, Abdulla A. @@aut@@ Alkhayarin, Mohamed @@aut@@ Ahmed, Ghalib @@aut@@
publishDateDaySort_date	2023-03-03T00:00:00Z
hierarchy_top_id	253724376
id	SPR053844521
language_de	englisch
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Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. 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author	Salman, Loay A.
spellingShingle	Salman, Loay A. misc Open reduction misc Closed reduction misc Intramedullary nail misc Femur misc Fractures Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
authorStr	Salman, Loay A.
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topic_title	Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis Open reduction (dpeaa)DE-He213 Closed reduction (dpeaa)DE-He213 Intramedullary nail (dpeaa)DE-He213 Femur (dpeaa)DE-He213 Fractures (dpeaa)DE-He213
topic	misc Open reduction misc Closed reduction misc Intramedullary nail misc Femur misc Fractures
topic_unstemmed	misc Open reduction misc Closed reduction misc Intramedullary nail misc Femur misc Fractures
topic_browse	misc Open reduction misc Closed reduction misc Intramedullary nail misc Femur misc Fractures
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title	Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
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title_full	Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
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author_browse	Salman, Loay A. Al-Ani, Abdallah Radi, Mohammed F. A. Abudalou, Abedallah F. Baroudi, Omar M. Ajaj, Abdulla A. Alkhayarin, Mohamed Ahmed, Ghalib
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author-letter	Salman, Loay A.
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title_sort	open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
title_auth	Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
abstract	Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. © The Author(s) 2023
abstractGer	Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. © The Author(s) 2023
abstract_unstemmed	Purpose This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16–0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). Conclusion This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies. © The Author(s) 2023
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container_issue	12
title_short	Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis
url	https://dx.doi.org/10.1007/s00264-023-05740-x
remote_bool	true
author2	Al-Ani, Abdallah Radi, Mohammed F. A. Abudalou, Abedallah F. Baroudi, Omar M. Ajaj, Abdulla A. Alkhayarin, Mohamed Ahmed, Ghalib
author2Str	Al-Ani, Abdallah Radi, Mohammed F. A. Abudalou, Abedallah F. Baroudi, Omar M. Ajaj, Abdulla A. Alkhayarin, Mohamed Ahmed, Ghalib
ppnlink	253724376
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isOA_txt	true
hochschulschrift_bool	false
doi_str	10.1007/s00264-023-05740-x
up_date	2024-07-03T22:25:09.174Z
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Methods Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. Results A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45–0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23–3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16–3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. 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Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis

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