title: [Treatment of clavicular fractures using intramedullary nailing or K-wire versus plating fixation: a meta-analysis].
abstract: OBJECTIVE
  TFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.
  
  
  METHODS
  Pubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.
  
  
  RESULTS
  Nine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.
  
  
  CONCLUSIONS
  The current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.
authors.forename: Ke-xue
authors.initials: KX
authors.lastname: Zhang
authors.forename: Jing-xin
authors.initials: JX
authors.lastname: Zhao
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhao
authors.forename: Li-cheng
authors.initials: LC
authors.lastname: Ng
authors.forename: Xiu-yun
authors.initials: XY
authors.lastname: Su
authors.forename: An-hua
authors.initials: AH
authors.lastname: Long
authors.forename: Zhi
authors.initials: Z
authors.lastname: Mao
authors.forename: Jin-hui
authors.initials: JH
authors.lastname: Zhang
authors.forename: Li-hai
authors.initials: LH
authors.lastname: Zhang
authors.forename: Pei-fu
authors.initials: PF
authors.lastname: Tang
mesh_terms: D001858:Bone Nails; D001864:Bone Wires; D002968:Clavicle / Q000293:injuries* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D016032:Randomized Controlled Trials as Topic