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Meta-Analysis
. 2018 Jun;97(24):e10917.
doi: 10.1097/MD.0000000000010917.

Suprapatellar versus infrapatellar intramedullary nailing for tibal shaft fractures: A meta-analysis of randomized controlled trials

Zhixue Gao  1 , Wei Han, Haigang Jia
Affiliations
Meta-Analysis

Suprapatellar versus infrapatellar intramedullary nailing for tibal shaft fractures: A meta-analysis of randomized controlled trials

Zhixue Gao et al. Medicine (Baltimore). 2018 Jun.

Abstract

Background and objective: The aim of this study was to compare the outcome of using tibial nails inserted by the suprapatellar approach with tibial nails inserted by the infrapatellar approach in a meta-analysis of randomized controlled trials (RCTs).

Methods: The following electronic databases were searched: PubMed (1966 to January 2018), EMBASE (1974 to January 2018), Cochrane Library (January 2018), Web of Science (1990 to January 2018). We also used Google Search Engine to search more potentially eligible studies until January 2018. The methodological qualities of included studies were assessed in accordance with the guidelines provided by the Cochrane Collaboration for Systematic Reviews. The statistical analysis all of included studies were performed by STATA 13.0 software. The outcomes were total blood loss, postoperative pain, range of motion (ROM), Lysholm knee score, fluoroscopy time, operation time, and postoperative complications.

Results: Four RCTs published between 2015 and 2017 were selected in the meta-analysis. There was a significant difference between suprapatellar and infrapatellar approach surgery in total blood loss, postoperative pain, ROM, Lysholm knee scores, and fluoroscopy times.

Conclusions: The suprapatellar approach for intramedullary nailing appears superior to the infrapatellar approach, with a reduction in total blood loss, improved postoperative pain, shorter fluoroscopy time, and better knee functionality outcomes. There was no increased incidence of postoperative complications between the 2 groups. Further research remains necessary.

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Conflict of interest statement

The authors report no conflicts of interests.

Figures

Figure 1
Figure 1
Flow chat shows article selection strategy.
Figure 2
Figure 2
Forest plot for total blood loss.
Figure 3
Figure 3
Forest plot for postoperative pain score.
Figure 4
Figure 4
Forest plot for Lysholm knee scores.
Figure 5
Figure 5
Forest plot for knee range of motion.
Figure 6
Figure 6
Forest plot for fluoroscopy times.
Figure 7
Figure 7
Forest plot for operation time.
Figure 8
Figure 8
Forest plot for postoperative complications.
See this image and copyright information in PMC

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