早期负重对髓内钉治疗股骨骨折预后的影响：一项系统回顾和荟萃分析

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-07 DOI:10.1016/j.jcot.2025.103091

Basem E. Ali , Ibrahim Alsawadi , Tarek Nayfeh , Ahmed E. Ali , Moustafa AL-Saeed

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引用次数: 0

摘要

髓内钉（IMN）治疗股骨骨折后早期负重（EWB）仍然是一个有争议的话题。该系统综述和荟萃分析在PROSPERO注册（CRD42025639691），并按照PRISMA指南进行，旨在评估EWB与延迟负重（DWB）对功能恢复、放射学愈合和并发症的影响。通过PubMed、Cochrane和Scopus的文献检索，确定了三个符合条件的研究，包括537名成年患者。分析显示EWB组和DWB组在影像学愈合率、不愈合率或种植体失败方面没有统计学上的显著差异。两组放射学愈合几乎相同（RR = 1.00, 95% CI: 0.96-1.05），不愈合（RR = 1.10, 95% CI: 0.68-1.79）和种植体失败（RR = 1.95, 95% CI: 0.55-6.87）也无显著差异。敏感性分析，包括排除中等质量的研究和模型比较，证实了这些发现的稳健性。大多数纳入的研究具有较高的方法学质量。根据GRADE框架，影像学愈合的证据确定性为中等，但并发症的证据确定性为低至极低。虽然早期动员可能是安全和有益的，但需要进一步的高质量前瞻性试验来加强这些结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

$Impact of early weight-bearing on outcomes of femur fractures treated with intramedullary nailing: A systematic review and meta-analysis$

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Impact of early weight-bearing on outcomes of femur fractures treated with intramedullary nailing: A systematic review and meta-analysis

Early weight-bearing (EWB) following intramedullary nailing (IMN) for femur fractures remains a debated topic. This systematic review and meta-analysis, registered with PROSPERO (CRD42025639691) and conducted in accordance with PRISMA guidelines, aimed to evaluate the impact of EWB versus delayed weight-bearing (DWB) on functional recovery, radiographic union, and complications. A literature search across PubMed, Cochrane, and Scopus identified three eligible studies comprising 537 adult patients. The analysis revealed no statistically significant differences between EWB and DWB groups in radiographic union rates, nonunion rates, or implant failure. Radiographic union was nearly identical across groups (RR = 1.00, 95 % CI: 0.96–1.05), with nonunion (RR = 1.10, 95 % CI: 0.68–1.79) and implant failure (RR = 1.95, 95 % CI: 0.55–6.87) also showing no significant differences. Sensitivity analyses, including exclusion of a moderate-quality study and model comparisons, confirmed the robustness of these findings. Most included studies were of high methodological quality. According to the GRADE framework, evidence certainty was moderate for radiographic union but low to very low for complications. While early mobilization may be safe and beneficial, further high-quality prospective trials are needed to strengthen these conclusions.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.