Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis.
AO type 31-A1
Extramedullary
Hip fracture
Intramedullary
Trochanteric
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
18
01
2023
accepted:
19
04
2023
medline:
31
7
2023
pubmed:
2
5
2023
entrez:
2
5
2023
Statut:
ppublish
Résumé
This systematic review and meta-analysis compared extramedullary fixation and intramedullary fixation for stable two-part trochanteric femoral fractures (AO type 31-A1) with regards to functional outcomes, complications, and surgical outcomes. Embase, Medline, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar were searched for randomized controlled trials (RCTs) and observational studies. Effect estimates were pooled across studies using random effects models. Results were presented as weighted risk ratio (RR) or weighted mean difference (MD) with corresponding 95% confidence interval (95% CI). Five RCTs (397 patients) and 14 observational studies (21,396 patients) were included. No significant differences in functional outcomes, complications, or surgical outcomes were found between extramedullary and intramedullary fixation devices, except for a difference in duration of surgery (MD 14.1 min, CI 5.76-22.33, p < 0.001) and intra-operative blood loss (MD 92.30 mL, CI 13.49-171.12, p = 0.02), favoring intramedullary fixation. Current literature shows no meaningful differences in complications, surgical, or functional outcomes between extramedullary and intramedullary fixation of stable two-part trochanteric femoral fractures. Both treatment options result in good outcomes. This study implicates that, costs should be taken into account when considering implants or comparing fixation methods in future research.
Identifiants
pubmed: 37129692
doi: 10.1007/s00402-023-04902-1
pii: 10.1007/s00402-023-04902-1
pmc: PMC10374813
doi:
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
5065-5083Investigateurs
Taco Gosens
(T)
Johannes H Hegeman
(JH)
Suzanne Polinder
(S)
Rudolf W Poolman
(RW)
Hanna C Willems
(HC)
Rutger G Zuurmond
(RG)
Informations de copyright
© 2023. The Author(s).
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