Article ; Online: Internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence.
2015 Volume 5, Page(s) 18195
Abstract: ... remain uncertain. We conducted a systematic review and meta-analysis of randomized ... internal fixation strategies, gamma nail (GN) and sliding hip screw (SHS). There is good evidence suggesting ... The relative effects of internal fixation strategies for intertrochanteric fracture after operation ...
| Abstract | The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to address this important issue. We searched PubMed, EMBASE and CENTRAL for RCTs that compared different internal fixation implants in patients with intertrochanteric fracture at 6-month follow-up or longer. We ultimately included 43 trials enrolling 6911 patients; most trials were small in sample sizes and events. Their risk of bias was generally unclear due to insufficient reporting. Because of these, no statistically significant differences were present from most of the comparisons across all the outcomes, and no definitive conclusions can be made. However, a number of trials compared two commonly used internal fixation strategies, gamma nail (GN) and sliding hip screw (SHS). There is good evidence suggesting that, compared to SHS, GN may increase the risk of cut out (OR = 1.87, 95% CI, 1.08 to 3.21), re-operation (OR = 1.61, 95% CI, 1.02 to 2.53), intra-operative (OR = 3.14, 95% CI, 1.34 to 7.35) and later fractures (OR = 3.67, 95% CI, 1.37 to 9.83). Future randomized trials or observational studies that are carefully designed and conducted are warranted to establish the effects of alternative internal fixation strategies for intertrochanteric fracture. |
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| MeSH term(s) | Blood Loss, Surgical ; Fracture Fixation, Internal/adverse effects ; Fracture Fixation, Internal/methods ; Hip Fractures/mortality ; Hip Fractures/surgery ; Hospitalization ; Humans ; Prospective Studies ; Quality of Life ; Randomized Controlled Trials as Topic ; Retreatment ; Treatment Outcome |
| Language | English |
| Publishing date | 2015-12-11 |
| Publishing country | England |
| Document type | Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review |
| ZDB-ID | 2615211-3 |
| ISSN | 2045-2322 ; 2045-2322 |
| ISSN (online) | 2045-2322 |
| ISSN | 2045-2322 |
| DOI | 10.1038/srep18195 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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