Meta-analysis On Distal Femoral Fractures Treated With Locking Plate And Retrograde Intramedullary Nail

OBJECTIVE:To compare the efficacy of locking plate versus retrograde intramedullary nail in the treatment of distal femoral fracturesMETHODS:We search the following data source (1980-2014.4) for randomized controlled trials(RCT):Pubmed, MEDLINE, Cochrane Library, EMBASE, OVID, VIP, CNKI, WANFANG DATA and Paper search. Assess the quality of all selected studies and extraction the data. Use the RevMan5.2software to analyze the data. Use Relative Risk (RR)to count dichotomous data, Weighted Mean Difference (WMD) to count continuous variables.RESULTS:Four RCTs with total of281patients were included. For methodology quality of literatures, all of included studies were low quality. The meta-analysis results showed that there were no statistically significant differences in the average operation time [MD=-10.65(-44.88,23.59), P>0.05], intraoperative blood loss [MD=-26.04(-98.75,46.67), P>0.05], excellent and good rate of postoperative [RR=1.08(0.99,1.19), P>0.05], the infection rate [RR=0.41(0.10,1.81), P>0.05] between two groups. Locking plate group had lower non-union, delayed union, malunion rate than Retrograde intramedullary nail group, there was significant difference[RR=0.38(0.17,0.84), P<0.05].CONCLUSION:According to the existing evidence, there were no differences between LP and RIN in the average operation time, intraoperative blood loss, excellent and good rate, and the infection rate. However, LP had lower non-union, delayed union, malunion rate comparing with RIN.