Design | RCT: intramedullary fixation v. nonoperative treatment | RCT: intramedullary fixation v. plate fixation | RCT: intramedullary fixation v. nonoperative treatment |
No. of intramedullary fixations | 60 | 17 | 29 |
Type of intramedullary fixation | Titanium endomedullary nail | Rockwood pin | Hagie pin |
Follow-up, mean (range) mo | 24 (22–27) | 12 (5–28) | 3 (1–12) |
Major complication rate, no. (%) |
Bone-healing problem |
Nonunion | 0 | 0 | 1 (3) |
Delayed union | 2 (3) | 0 | 1 (3) |
(Symptomatic) malunion | 0 | 0 | NA |
Infection, deep | NA | NA | 2 (7) |
Implant breakage/failure/irritation, mechanical failure | 2 (3) | 1 (6) | 1 (3) |
Refracture after pin removal | 1 (2) | NA | 2 (7) |
Minor complication rate, no. (%) |
Implant breakage/failure/irritation |
Irritation | 5 (5) | 1 (6) | 9 (31) |
Migration/telescoping | 7 (12) | NA | NA |
(Medial/lateral) protrusion | 12 (20) | NA | NA |
Infection, wound | 1 (2) | 0 | 4 (14) |
Routine nail removal | NA | 17 (100) | 26 (90) |
Nonroutine nail removal | 0 | 0 | 3 (10) |
Neurovascular problem |
Brachial plexus symptoms | 0 | 2 (12) | 1 (3) |
Regional pain syndrome | 0 | 0 | NA |
Intramedullary fixation device shortening | 12 (20) | NA | NA |