Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis
Abstract Background Hip fractures are still unsolved problems nowadays. We evaluated the functional outcomes and complications in the treatment of hip fractures (AO/OTA31A1-A3) to find potential difference and risk between intramedullary nail (IMN) and dynamic hip screw (DHS). Method We searched Pub...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06715-0 |
| _version_ | 1797774428646408192 |
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| author | Fei Yu Yang-Wei Tang Ju Wang Zhi-Cheng Lin Yu-Bin Liu |
| author_facet | Fei Yu Yang-Wei Tang Ju Wang Zhi-Cheng Lin Yu-Bin Liu |
| author_sort | Fei Yu |
| collection | DOAJ |
| description | Abstract Background Hip fractures are still unsolved problems nowadays. We evaluated the functional outcomes and complications in the treatment of hip fractures (AO/OTA31A1-A3) to find potential difference and risk between intramedullary nail (IMN) and dynamic hip screw (DHS). Method We searched PubMed, Embase, Cochrane library up to 19 June 2023 and retrieved any studies comparing IMN and DHS in treatment of Hip fractures. The main outcomes and complications were extracted from the included studies. The fixed-effect model was selected to pool the data for homogeneous studies (I2 < 50%). Otherwise, the random effects model was selected (heterogeneity, I2 > 50%). The analysis of sensitivity and subgroup was performed to explore the homogeneous studies among studies. The p-value of less than 0.05 was considered statistically significant. Results 30 RCT studies were included in this meta-analysis. There were significant difference of in the items of blood loss, screening time, femoral neck shortening, non-union, and femoral fractures (p < 0.05). Significant difference was found in the parameter of open reduction of fracture after sensitive analysis (p < 0.05). No significant difference was found in the parameter of Mobility Score at the last follow-up after sensitive analysis (p ≥ 0.05). There was no significant difference in the parameters of open reduction of fracture, required blood transfusion, mean surgical time, hospital stays, time to healing, mean Harris Hip Score, infection, cut out, poor reduction, breakage of implant, failure of fixation, reoperation, and systemic complications of chest infection, decubital ulcer, urinary tract infection and persistent pain in the hip (p ≥ 0.05). Conclusions Our meta-analysis revealed that hip fractures treated with IMN have merits with lower rate of blood loss, femoral neck shortening and non-union; shortcoming of increased risk of femoral fractures. It is suggested that special attention should be paid to the risk of femoral fracture when intramedullary nail was inserted in the intraoperative. |
| first_indexed | 2024-03-12T22:20:55Z |
| format | Article |
| id | doaj.art-939251cb8e6f4594a0815c6c5aface3b |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-12T22:20:55Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-939251cb8e6f4594a0815c6c5aface3b2023-07-23T11:03:53ZengBMCBMC Musculoskeletal Disorders1471-24742023-07-0124111410.1186/s12891-023-06715-0Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysisFei Yu0Yang-Wei Tang1Ju Wang2Zhi-Cheng Lin3Yu-Bin Liu4College of Management, Guangdong Polytechnic Normal UniversityDepartment of Orthopedics, Huaiji People’s HospitalDepartment of Orthopedics, Huaiji People’s HospitalOrthopedics Center, Department of Orthopedics and Traumatology, Zhujiang Hospital, Southern Medical UniversityOrthopedics Center, Department of Orthopedics and Traumatology, Zhujiang Hospital, Southern Medical UniversityAbstract Background Hip fractures are still unsolved problems nowadays. We evaluated the functional outcomes and complications in the treatment of hip fractures (AO/OTA31A1-A3) to find potential difference and risk between intramedullary nail (IMN) and dynamic hip screw (DHS). Method We searched PubMed, Embase, Cochrane library up to 19 June 2023 and retrieved any studies comparing IMN and DHS in treatment of Hip fractures. The main outcomes and complications were extracted from the included studies. The fixed-effect model was selected to pool the data for homogeneous studies (I2 < 50%). Otherwise, the random effects model was selected (heterogeneity, I2 > 50%). The analysis of sensitivity and subgroup was performed to explore the homogeneous studies among studies. The p-value of less than 0.05 was considered statistically significant. Results 30 RCT studies were included in this meta-analysis. There were significant difference of in the items of blood loss, screening time, femoral neck shortening, non-union, and femoral fractures (p < 0.05). Significant difference was found in the parameter of open reduction of fracture after sensitive analysis (p < 0.05). No significant difference was found in the parameter of Mobility Score at the last follow-up after sensitive analysis (p ≥ 0.05). There was no significant difference in the parameters of open reduction of fracture, required blood transfusion, mean surgical time, hospital stays, time to healing, mean Harris Hip Score, infection, cut out, poor reduction, breakage of implant, failure of fixation, reoperation, and systemic complications of chest infection, decubital ulcer, urinary tract infection and persistent pain in the hip (p ≥ 0.05). Conclusions Our meta-analysis revealed that hip fractures treated with IMN have merits with lower rate of blood loss, femoral neck shortening and non-union; shortcoming of increased risk of femoral fractures. It is suggested that special attention should be paid to the risk of femoral fracture when intramedullary nail was inserted in the intraoperative.https://doi.org/10.1186/s12891-023-06715-0Intramedullary nailDynamic hip screwHip fracturesmeta-analysis |
| spellingShingle | Fei Yu Yang-Wei Tang Ju Wang Zhi-Cheng Lin Yu-Bin Liu Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis BMC Musculoskeletal Disorders Intramedullary nail Dynamic hip screw Hip fractures meta-analysis |
| title | Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis |
| title_full | Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis |
| title_fullStr | Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis |
| title_full_unstemmed | Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis |
| title_short | Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis |
| title_sort | does intramedullary nail have advantages over dynamic hip screw for the treatment of ao ota31a1 a3 a meta analysis |
| topic | Intramedullary nail Dynamic hip screw Hip fractures meta-analysis |
| url | https://doi.org/10.1186/s12891-023-06715-0 |
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