Meta Analysis Of Plate Internal Fixation And Elastic Intramedullary Nail Fixation In The Treatment Of Displaced Mid-clavicle Fracture

bjective: Through multiple database retrieval at home and abroad about steel plate internal fixation(PF)and elastic intramedullary nail fixation(IF)in the treatment of type shift re-setting clinical literature contrast,two groups of patients in the references of relevant data extract,screening,induction and summary,and system evaluation and comparison analysis,the clinical treatment of choice for re-setting to provide the reference.Methods:Retrieval steps according to the Cochrane collaboration related design requirements,mainly in the following database query,search from database construction,to 2017 published march period and displacement clavicle middle fracture internal fixation of the related literatures and research: the Cochrane Library databases,Pubmed database,Science Direct database,Embase database,Elsevier Science Direct,VIP period(VIP)issue of network database,China hownet(CNKI),a database of ten thousand in China.Keywords: elastic intramedullary nail,plate,clavicle fracture,internal fixation;English language search keywords: elastic intramedullary nail,steel plate,the clavicle fracture,internal fixation.In addition,the author also expanded the search through the websites of university libraries to include relevant research literatures that met the requirements.After the final summary of the valid data in the articles,the author completed the meta-analysis of the extracted valid data with Review 5.3 software.Results: A total of 416 literatures were obtained from the aforementioned database after searching relevant keywords.After removal,281 articles were left.After a preliminary reading of the title and abstract,236 papers were removed,leaving 45 papers.After reading the full text again,24 articles were excluded.Finally,21 articles met the inclusion criteria of the meta-analysis,and a total of 1692 patients were included,including 833 in the plate group(PF)and 859 in the intramedullary nail fixation group(IF).Finally,relevant systematic analysis was made on the indicators and data in the obtained literature,including upper limb function score(DASH score),Constant score,major complications,minor complications,wound length,blood loss,operation time,hospital stay,healing time.In operation time [MD = 18.62,95% CI(20.75,16.49)],blood loss,[MD = 56.23,95% CI(68.02,62.44)],length of incision,[MD = 5.53,95% CI(6.56,4.49)],the length of time [MD = 1.01,95% CI(1.13,0.89)],fracture healing time [MD = 1.39,95% CI(1.98,0.80)],The results of elastic intramedullary nail group(IF)were better than those of plate group(PF).In terms of upper limb function score(DASH)at 6 months after surgery,the elastic intramedullary nail group(IF)was better than the steel plate group(PF)(P < 0.05).In terms of major complications [OR=0.61,95%ci(0.39,0.93)],the major complications in the elastic intramedullary nail group(IF)were significantly reduced compared with those in the plate group(PF).The incidence of minor complications and internal fixation reremoval was similar between the two groups.Conclusions:The results of meta-analysis indicated that elastic intramedullary nailing(IF)was superior to plate internal fixation(PF)in surgical indicators,functional recovery and fracture healing for the treatment of displaced mid-clavicle fracture,which provided strong evidence for the clinical use of elastic intramedullary nailing for the treatment of displaced mid-clavicle fracture.