الفهرس 
Title : Outcomes of three different internal fixation techniques in the treatment of neglected non-united distal femur fractures: meta-analysis study
ContentsOnly 14 pages are availabe for public view
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Abstract
Non-union in distal femoral fractures is frequently associated with complex fracture patterns and poor bone quality. There is still debate about which treatment modality is best, with research comparing lateral locking plate (LLP), plate over retrograde intramedullary nail (RIMN) and dual plating (DP) fixation showing conflicting evidence.
Methods: We conducted a systematic search on four different databases: Pubmed, Web of Science, Cochrane Central, and SCOPUS. The search was done by two independent researches and differences was sorted out and solved by third independent researcher according to the PRISMA statement and the guidelines mentioned by the Cochrane’s handbook of systematic reviews. Eligibility criteria was predefined with clearly stated inclusionandexclusioncriteriaofstudies.Afterclearscreeningofstudies between two independent participants and solving contradictions by a third participant, our systematic research yielded 7 eligible studies.
Data extraction was done including demographic data of subject, study design and outcomes to be measured. The outcome measures included union rate, time to union, infection rate and reoperation. Statistical analysis of outcomes were conducted by Comprehensive Meta-analysis software version 2.0 (http://www.meta-analysis.com) by using fixedeffect model.
Results: Study was conducted on 7 studies. There were 125 patients in total. Patients were followedup for an average of 17.2 months and had an average age of 52.5 years. The overall incidence of union was 92.8% (116/125), 95.8% (46/48) in the Dual plating group, 94.7% (18/19) in the plateoverretrogradenailgroupand89.6%(52/58)intheLLPgroupfor
an average duration of 9.43 months. One studyreported 20% (4/20) cases needed reoperation when treated with LLP groups. Overall infection rate was seen 6.9% in (7/101) cases.
Conclusion: This study concluded a statistically significant favorable clinical outcome and equal complications of Dual plating procedures when compared to Plate over retrograde intramedullary fixation and Lateral locking plate fixation procedures but our findings support DP procedures as an effective technique with higher rates of union and possibly lower revision rates. The observational study designs of the included studies limit our finding, so more randomised controlled trials are needed to provide higher quality data. The applicability of our findings is limited due to the small sample size of included studies. To obtain additional effectiveness and quality measurements, we require comparison research with a control group. These limitations in our study have an impact on our conclusion and highlight the need for more research.
Studydesign:Meta-analysisstudy