Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis

BackgroundLong bone fractures, especially in the lower limbs, are highly prevalent in orthopedic practice. These fractures can significantly impair patients' mobility and quality of life. Intramedullary nails are a mainstay treatment, offering reliable fracture fixation. However, the addition o...

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Main Authors: Zhaoguo Jin, Ding Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1560150/full
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author Zhaoguo Jin
Ding Wang
author_facet Zhaoguo Jin
Ding Wang
author_sort Zhaoguo Jin
collection DOAJ
description BackgroundLong bone fractures, especially in the lower limbs, are highly prevalent in orthopedic practice. These fractures can significantly impair patients' mobility and quality of life. Intramedullary nails are a mainstay treatment, offering reliable fracture fixation. However, the addition of blocking screws has introduced an element of uncertainty regarding surgical outcomes. This meta-analysis evaluated the efficacy and complications of blocking screw fixation for lower limb long bone fractures (LLLBF).MethodsA comprehensive and systematic search was conducted across eight databases, namely the Cochrane Library, PubMed, EMbase, Web of Science, CNKI, China Biomedical Literature Database (CBM), VIP, and WanFang, to identify relevant controlled trials. Before data analysis, the quality of each study was rigorously assessed. Subsequently, the data were analyzed using the Review Manager 5.3 (RevMan 5.3) software to ensure a reliable and accurate synthesis of the evidence.ResultsA total of 15 studies were incorporated into the analysis. Compared with the control group, the experimental group demonstrated a significantly shorter fracture healing time (standardized mean difference, SMD = −2.18; 95% confidence interval, CI: −3.17 to −1.20; P < 0.001), suggesting a substantial effect in favor of the intervention. Additionally, the experimental group had a longer operation time (SMD = 15.81, 95% CI: 4.28, 27.34, P = 0.007), less intraoperative bleeding (SMD = −75.60, 95% CI: −127.93, −23.27, P = 0.005), and fewer complications (odds ratio, OR = 0.51, 95% CI: 0.31, 0.84, P = 0.008). However, no significant difference was observed in the fracture healing rates between the two groups (OR = 1.09, 95% CI: 0.98, 1.20, P = 0.098).ConclusionThe findings of this study suggest that the use of intramedullary nails in conjunction with blocking screws could potentially be an effective treatment option for patients with lower limb long bone fractures. However, to confirm this efficacy, additional high - quality research, preferably well-designed randomized controlled trials with large sample sizes and long-term follow - up, is warranted.
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spelling doaj-art-8f530cd490ea4d91b66df881b68bf4c72025-08-20T02:41:10ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-03-011210.3389/fsurg.2025.15601501560150Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysisZhaoguo JinDing WangBackgroundLong bone fractures, especially in the lower limbs, are highly prevalent in orthopedic practice. These fractures can significantly impair patients' mobility and quality of life. Intramedullary nails are a mainstay treatment, offering reliable fracture fixation. However, the addition of blocking screws has introduced an element of uncertainty regarding surgical outcomes. This meta-analysis evaluated the efficacy and complications of blocking screw fixation for lower limb long bone fractures (LLLBF).MethodsA comprehensive and systematic search was conducted across eight databases, namely the Cochrane Library, PubMed, EMbase, Web of Science, CNKI, China Biomedical Literature Database (CBM), VIP, and WanFang, to identify relevant controlled trials. Before data analysis, the quality of each study was rigorously assessed. Subsequently, the data were analyzed using the Review Manager 5.3 (RevMan 5.3) software to ensure a reliable and accurate synthesis of the evidence.ResultsA total of 15 studies were incorporated into the analysis. Compared with the control group, the experimental group demonstrated a significantly shorter fracture healing time (standardized mean difference, SMD = −2.18; 95% confidence interval, CI: −3.17 to −1.20; P < 0.001), suggesting a substantial effect in favor of the intervention. Additionally, the experimental group had a longer operation time (SMD = 15.81, 95% CI: 4.28, 27.34, P = 0.007), less intraoperative bleeding (SMD = −75.60, 95% CI: −127.93, −23.27, P = 0.005), and fewer complications (odds ratio, OR = 0.51, 95% CI: 0.31, 0.84, P = 0.008). However, no significant difference was observed in the fracture healing rates between the two groups (OR = 1.09, 95% CI: 0.98, 1.20, P = 0.098).ConclusionThe findings of this study suggest that the use of intramedullary nails in conjunction with blocking screws could potentially be an effective treatment option for patients with lower limb long bone fractures. However, to confirm this efficacy, additional high - quality research, preferably well-designed randomized controlled trials with large sample sizes and long-term follow - up, is warranted.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1560150/fullblocking screwsintramedullary nailtibiafemurfracturesfixation
spellingShingle Zhaoguo Jin
Ding Wang
Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
Frontiers in Surgery
blocking screws
intramedullary nail
tibia
femur
fractures
fixation
title Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
title_full Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
title_fullStr Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
title_full_unstemmed Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
title_short Efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture: a meta-analysis
title_sort efficacy and complications of blocking screws fixation in the treatment of lower limb long bone fracture a meta analysis
topic blocking screws
intramedullary nail
tibia
femur
fractures
fixation
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1560150/full
work_keys_str_mv AT zhaoguojin efficacyandcomplicationsofblockingscrewsfixationinthetreatmentoflowerlimblongbonefractureametaanalysis
AT dingwang efficacyandcomplicationsofblockingscrewsfixationinthetreatmentoflowerlimblongbonefractureametaanalysis