Systenatic Review Of Retrograde Intramedullary Nail Versus Screws And Plates Surgical Treatments Of Distal Femoral Fracture In Adult

Objective To determine the effect of retrograde intramedullary nail and plate for type A and type C fracture of distal femoral in adult. Methods Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified from MEDLINE (1966-July, 2008), EMBASE (1966-July, 2008) , The Cochrane Library (Issue 2, 2008), CBMdisc (1979-July, 2008). The relative orthopedic papers published in Chinese journals and meeting materials in recent 5 years were collected by hand. RCTs and CCTs were included. Date were extracted by two reviewers with designed extraction form. The quality of trials was critically assessed. RevMan 4.2.10 software was used for data analysis. Results Two RCTs and one CCT were included. The meta-analysis showed that there was no significant differences between retrograde intramedullary nail and plate fixation in the rates of nonunion, secondary operation, malunion, arthralgia, knee contracture and operative region infection, which belonged to postoperative complication. Conclusion Compared with retrograde intramedullary nail and plate fixation have no significant differences in the rates of nonunion, secondary operation, malunion, arthralgia, knee contracture and operative region infection, which belonged to postoperative complication, in healing a distal femur fracture in adults. Due to the insufficient cases, more large-scale, high-quality randomized controlled trials are still needed .