title: System evaluation on reamed and non-reamed intramedullary nailing in the treatment of closed tibial fracture.
abstract: OBJECTIVE
  To systematically evaluate the clinical efficacy of reamed and nonreamed intramedullary nailing in treatment of closed tibial fractures with Cochrane systematic review methods.
  
  
  METHODS
  According to the Cochrane systematic review methods, literatures were retrieved from Cochrane library, PubMed, EMbase and other database. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials about reamed and nonreamed intramedullary nailing in the treatment of closed tibial fractures were collected and RevMan 5.0 was chosen for meta-analysis.
  
  
  RESULTS
  A total of seven studies were included in this meta-analysis. Reamed intramedullary nailing was better than nonreamed intramedullary nailing in nonunion rate [P = 0.02, RR = 0.46, 95% CI: (0.24, 0.91)] and implant failure rate [P <0.0001, RR = 0.36, 95% CI: (0.22, 0.57)]. No statistically significant difference was observed in malunion rate, compartment syndrome rate, postoperative infection [P = 0.18, RR = 0.50, 95% CI: (0.18, 1.383); P = 0 43, RR = 0.77, 95% CI: (0.40, 1.48); P = 0.27, RR = 0.38, 95% CI: (0.01, 7.87)].
  
  
  CONCLUSIONS
  Compared with the nonreamed intramedullary nailing, reamed intramedullary nailing can lead to better outcome in the treatment of closed tibial fractures.
authors.forename: Chun-xiao
authors.initials: CX
authors.lastname: Li
authors.forename: Hong-jing
authors.initials: HJ
authors.lastname: Zhao
authors.forename: Wan-qiu
authors.initials: WQ
authors.lastname: Zhao
authors.forename: Yong-qing
authors.initials: YQ
authors.lastname: Xu
mesh_terms: D005594:Fracture Fixation, Intramedullary / Q000379:methods* / Q000592:standards; D017102:Fracture Healing / Q000502:physiology; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome