Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence

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 compar...

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Main Authors: Yu, J., Zhang, Chao, Li, Ling, Kwong, J., Xue, L., Zeng, X., Tang, Li, Li, Y., Sun, X.
Format: Journal Article
Published: Nature Publishing Group 2015
Online Access:http://hdl.handle.net/20.500.11937/25782
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author Yu, J.
Zhang, Chao
Li, Ling
Kwong, J.
Xue, L.
Zeng, X.
Tang, Li
Li, Y.
Sun, X.
author_facet Yu, J.
Zhang, Chao
Li, Ling
Kwong, J.
Xue, L.
Zeng, X.
Tang, Li
Li, Y.
Sun, X.
author_sort Yu, J.
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-257822017-09-13T15:23:55Z Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence Yu, J. Zhang, Chao Li, Ling Kwong, J. Xue, L. Zeng, X. Tang, Li Li, Y. Sun, X. 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/25782 10.1038/srep18195 Nature Publishing Group fulltext
spellingShingle Yu, J.
Zhang, Chao
Li, Ling
Kwong, J.
Xue, L.
Zeng, X.
Tang, Li
Li, Y.
Sun, X.
Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title_full Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title_fullStr Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title_full_unstemmed Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title_short Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence
title_sort internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence
url http://hdl.handle.net/20.500.11937/25782