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首页> 美国卫生研究院文献>Strategies in Trauma and Limb Reconstruction >Uniting the un-united: should established non-unions of femoral shaft fractures initially treated with IM nails be treated by plate augmentation instead of exchange IM nailing? A systematic review
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Uniting the un-united: should established non-unions of femoral shaft fractures initially treated with IM nails be treated by plate augmentation instead of exchange IM nailing? A systematic review

机译：团结不团结：最初用IM钉治疗的已建立的股骨干骨折不愈合是否应该通过钢板加固而不是交换IM钉治疗？系统评价

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摘要

The majority of femoral fractures are surgically treated with intramedullary nails. Non-union rate is low but challenging and costly if it occurs. There have been encouraging results from the use of augmentative plating as a treatment for non-union of femoral fractures. We performed a systematic review of the literature to compare union rates, time to union and complications between exchange nailing and augmentative plating as a primary procedure following a diagnosis of femoral non-union following initial nailing. We found a total of 21 papers, which found the mean union rate of augmentative plating to be 99.8% compared to 74% (P = 2.05−12) found for exchange nailing. Times to union were comparable at 5.9 months for augmentative plating and 6.3 months for exchange nailing (P = 0.68916), and complication rate was 4% for augmentative plating compared to 20% for exchange nailing. From the evidence available, plate augmentation provides a more reliable union rate if used as the first operative intervention on a non-union of a femoral fracture compared to exchange nailing.Level of Evidence IV Systematic review of therapeutic studies.
机译：大多数股骨骨折均采用髓内钉进行手术治疗。不工会率很低，但是如果发生的话，则具有挑战性且代价高昂。使用增强钢板作为股骨骨折不愈合的治疗方法获得了令人鼓舞的结果。我们对文献进行了系统的综述，以比较在最初的钉子诊断为股骨不愈合之后，作为主要手术的钉扎率，换钉时间和置换钉与增强钢板之间的并发症。我们发现共有21篇论文，发现补钉的平均联合率为99.8％，而交换钉的平均联合率为74％（P = 2.05 -12 ）。联合手术的时间与强化板的5.9个月和置换钉的6.3个月相当（P = 0.68916），强化板的并发症发生率为4％，而置换钉的并发症发生率为20％。从现有证据来看，与交换钉相比，如果作为首次治疗股骨骨折不愈合的手术干预，钢板隆起可提供更可靠的联合率。证据级别IV治疗研究的系统评价。

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