Xiao-Yuan Liu,Meng Jiang,Cheng-La Yi,Xiang-Jun Bai,David J. Hak.[J].Chin J Traumatol,2016,19(3):160-163. [doi]
Early intramedullary nailing for femoral fractures in patients with severe thoracic trauma: A systemic review and meta-analysis
  
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KeyWord: Thoracic injuries Femoral fractures Fracture fixation Intramedullary Meta-analysis
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Xiao-Yuan Liu Department of Orthopaedic Surgery, Daye People's Hospital, Daye, 435100, China 
Meng Jiang Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China 
Cheng-La Yi Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China 
Xiang-Jun Bai Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China 
David J. Hak Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado Denver, School of Medicine, Denver, 80204, USA 
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Abstract:
      Purpose: Early intramedullary nailing (IMN) within the first 24 h for multiply injured patients with femoral fracture and concomitant thoracic trauma is controversial. Previously published studies have been limited in size and their outcomes have been inconclusive. A meta-analysis was conducted to evaluate the available data in order to guide care and help improve the outcomes for these patients. Methods: We searched the literature up to December 2011 in the main medical search engines and identified 6 retrospective cohort studies that explored the safety of early IMN in patients with both femoral fracture and chest injury. Our primary outcome was the rates of pulmonary complication (pneumonia, adult respiratory distress syndrome, fat embolism syndrome), multiple organ failure (MOF) and mortality. Results: We found no statistically significant difference in the rate of pulmonary complications, MOF or mortality in the patients treated with early IMN. Conclusion: Early IMN for femoral fractures does not increase the mortality and morbidity in chestinjured patients in the studies analyzed.
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