SynthesisInternational orthopaedics2023
Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis.
Synthesis in International orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Article
- Repurposing Metformin to Promote Fracture Callus Maturation via AMPK-Driven Metabolic Activation.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026Article
- Effect of postoperative fracture gap on bone union in femoral diaphyseal fractures treated with intramedullary nailing: a retrospective clinical study.Journal of orthopaedic surgery and research · 2026Article
- Limited open reduction versus closed reduction in retrograde nailing for mid-distal femoral fractures.Journal of orthopaedic surgery and research · 2025Article
- Wedge fragments: no significant impact on bone healing in femoral shaft fractures treated with intramedullary nailing.Archives of orthopaedic and trauma surgery · 2025Article
- Experimental study on the biomechanical loading of a four-dimensional plate for the fixation of femoral shaft fractures.BMC musculoskeletal disorders · 2025Article
- Outcome of femoral fractures treated with cerclages and intramedullary nailing.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Article
- The Recent Developments of Thermomechanical Processing for Biomedical Mg Alloys and Their Clinical Applications.Materials (Basel, Switzerland) · 2025Review
- Clinical outcomes of closed reduction vs. small-incision-assisted open reduction with intramedullary nailing in complex comminuted femoral shaft fractures (AO/OTA 32-C): a retrospective cohort study.Frontiers in surgery · 2025Article
- Comparison of treatment results of femoral shaft fracture with two methods of intramedullary nail (IMN) and plate.BMC surgery · 2024Article
- Standard or Fin SIGN® nail? which option is better for the treatment of femoral fractures in low and middle-income countries?International orthopaedics · 2024Article
- Exploring Quality of Life and Mortality in Pertrochanteric Fragility Hip Fractures in Northern Greece: A Single Tertiary Center Study.Journal of clinical medicine · 2024Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures.
methodsFour databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines.
resultsA total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45-0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23-3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16-3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16-0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS).
conclusionThis study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies.
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