Early intramedullary nailing for femoral fractures in patients with severe thoracic trauma: A systemic review and meta-analysis.
OBJECTIVE
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.


CONCLUSIONS
Early IMN for femoral fractures does not increase the mortality and morbidity in chest- injured patients in the studies analyzed.
Department of Orthopaedic Surgery, Daye People's Hospital, Daye, 435100, China.
Xiao-Yuan
XY
Liu
Meng
M
Jiang
C-L
CL
Yi
Xiang-Jun
XJ
Bai
David-J
DJ
Hak
D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D009102:Multiple Organ Failure / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D012128:Respiratory Distress Syndrome / Q000453:epidemiology; D013898:Thoracic Injuries / Q000601:surgery*