Table 1 Characteristics of the studies included in the systematic review and meta-analysis
Lead Author, Publication Date | Location | Year of study | Mean age (years) | % male | Mean follow up (months) | Participants n | Two-stage/ one-stage | Surgical implant | Re-infections/ persisting infections n (%) | Fusion rate % (time to fusion - months) | Major complications n | Reoperations n | Postoperative limb length discrepancy (mm) | Quality score |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Intramedullary nail | ||||||||||||||
Hungerer et al., 2017 [26] | Germany | 2003–2012 | 68.6 | 43 | 53 (12–119) | 55 | NS | Short modular nail | 12 (21.8%) | NS | 13 | 20 | 18 | 9/16 |
Friedrich et al., 2017 [23] | Germany | 2008–2014 | 70.2 | NS | 31 (12–74) | 37 | 37/0 | Short modular nail | 5 (13.5%) | NS | 2 | 7 | 22 | 10/16 |
Hawi et al., 2015 [5] | Germany | 2002–2012 | 68.8 | 63 | 67 (24–143) | 27 | 0/27 | Short modular cemented nail | 4 (14.8%) | NS | 0 | 3 | NS | 11/16 |
Röhner et al., 2015 [12] | Germany | 1997–2013 | 68 | 31 | 71 (12–204) | 26 | 26/0 | Short modular cemented nail | 13 (50%) | NS | 0 | 13 | NS | 10/16 |
Miralles-Muñoz et al., 2014 [29] | Spain | 2001–2010 | 74.6 | 14 | 50 (36–60) | 29 | 29/0 | Short modular cemented nail | 2 (6.9%) | NS | 4 | 3 | 8 | 12/16 |
Scarponi et al., 2014 [33] | Italy | 2000–2011 | 65 | 47 | 62 (24–105) | 38 | 38/0 | Short modular cementless nail | 4 (10.5%) | NS | 5 | 5 | 13 | 9/16 |
Iacono et al., 2013 [10] | Italy | 2004–2009 | 69.3 | NS | 34(13–72) | 21 | 21/0 | Short modular cementless nail | 3 (14.3%) | NS | 0 | 3 | 8 | 9/16 |
Putman et al., 2013 [31] | France | 2005–2008 | 67 | NS | 50 (28–90) | 31 | 25/6 | Short modular cementless nail | 6 (19.4%) | 68 (NS) | 10 | 3 | 10 | 10/16 |
Barton et al., 2008 [17] | UK | 1993–2004 | NS | NS | 53 | 10 | 9/1 | Short modular nail | 1 (10%) | 100 (8) | 2 | 2 | NS | 8/16 |
Talmo et al., 2007 [34] | USA | NS | 67 | 41 | 48 (13–114) | 29 | 25/4 | Long modular cementless nail | 4 (13.8%) | 83 (6) | 2 | 5 | 30 | 11/16 |
Bargiotas et al., 2006 [16] | USA | 1999–2003 | 68 | 42 | 49 (18–72) | 12 | 12/0 | Long locked cementless nail | 2 (16.6%) | 83 (5.5) | 2 | 2 | 55 | 10/16 |
Crockarell and Mihalko, 2005 [19] | USA | 1991–2000 | 70.5 | 40 | 68 (24–96) | 10 | 9/1 | Long locked cementless nail | 1 (10%) | 100 (NS) | NS | NS | 37 | 9/16 |
Domingo et al., 2004 [22] | Spain | 1990–2001 | 67.8 | 50 | Minimum 1 year | 10 | 10/0 | Short locked cementless nail | 1 (10%) | 90 (5) | 2 | 1 | NS | 8/16 |
Volpi et al., 2004 [35] | France | 1997–2001 | 68.6 | 43 | 19 | 12 | 12/0 | Short modular cementless nail | 2 (16.6%) | 100 (3.6) | 1 | 1 | NS | 7/16 |
Gore and Gassner, 2003 [24] | USA | 1977–2001 | 71.5 | 56 | 54 (12–288) | 16 | 14/2 | Long Kuntscher or modular nail | 2 (12.5%)) | 87.5 (NS) | 3 | 4 | NS | 8/16 |
Waldman et al., 1999 [36] | USA | NS | 64 | 38 | 29 (24–90) | 21 | 21/0 | Short modular cementless nail | 0 (0%) | 95 (6.3) | 2 | 2 | NS | 8/16 |
Lai et al., 1998 [28] | Taiwan | 1988–1994 | 68.2 | 43 | 47 (18–94) | 28 | 8/20 | Short locked cementless nail | 1 (3.6%) | 93 (5.2) | 2 | 1 | 25 | 9/16 |
Wilde and Stearns, 1989 [37] | USA | 1983–1988 | 65 | 33 | Minimum 24 | 10 | 10/0 | Long Kuntscher nail | 3 (30%) | 60 (6.6) | 6 | 6 | 36 | 8/16 |
External fixator | ||||||||||||||
Balci, 2016 [13] | Turkey | 1999–2012 | 67 | 18 | 51 | 17 | 17/0 | Unilateral EF | 1 (6%) | 94 (7.6) | 4 | 6 | 29 | 11/16 |
Corona et al., 2013 [18] | Spain | 2004–2009 | 81 | 48 | 50 (12–81) | 21 | 0/21 | Unilateral EF | 3 (14%) | 81 (10.3) | NS | NS | 47 | 9/16 |
Iacono et al., 2013 [10] | Italy | 2001–2004 | 68.5 | NS | 93(82–110) | 10 | 10/0 | Semi circular Hoffmann EF | 0 (0%) | 90 (6.7) | 1 | 2 | 45 | 9/16 |
Reddy et al., 2011 [32] | India | 2003–2010 | 62.2 | 63 | 46 (12–84) | 16 | 3/16 | Ilizarov frame | 1 (6%) | 94 (6.6) | 6 | 6 | 44 | 9/16 |
Parratten et al., 2007 [30] | France | 1990–2003 | 64.8 | 43 | 88 (12–162) | 14 | 6/8 | 2 unilateral EF | 0 (0%) | 93 (7.3) | 2 | 2 | 45 | 9/16 |
Klinger et al., 2006 [27] | Germany | 1990–2002 | 66.2 | 61 | 56 (24–132) | 18 | 11/7 | Unilateral EF | 1 (6%) | 83 (6.3) | 3 | 2 | 36 | 9/16 |
Domingo et al., 2004 [22] | Spain | 1990–2001 | 69.1 | 45 | Minimum 1 year | 11 | 11/0 | Unilateral EF (3) | 0 (0%) | 100 (6.7) | 1 | 0 | NS | 8/16 |
Biplanar EF (8) | 100 (6.1) | |||||||||||||
David et al., 2001 [20] | Israel | 1988- | 65.9 | 39 | 41 (18–60) | 10 | NS | Ilizarov frame | 0 (0%) | 100 (6.4) | 1 | 0 | 37 | 8/16 |
Hak et al., 1995 [25] | USA | 1973–1990 | 58.5 | 45 | 43 (12–186) | 20 | NS | Unilateral EF (7) | 1 (5%) | 57 (7.1) | 13 | 4 | NS | 8/16 |
Biplanar EF (13) | 62 (7.1) | |||||||||||||
De Cloedt et al., 1994 [21] | Belgium | 1984–1992 | 67.7 | 40 | 68 (14–108) | 15 | NS | 2 unilateral EF | 8 (53%) | 67 (7.3) | NS | 8 | NS | 8/16 |