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BMC Musculoskeletal Disorders

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Open Access 01-12-2023 | Dynamic Hip Screw | Research

Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis

Authors: Fei Yu, Yang-Wei Tang, Ju Wang, Zhi-Cheng Lin, Yu-Bin Liu

Published in: BMC Musculoskeletal Disorders | Issue 1/2023

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.

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Title: Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis
Authors: Fei Yu
Yang-Wei Tang
Ju Wang
Zhi-Cheng Lin
Yu-Bin Liu
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Dynamic Hip Screw
Femoral Fracture
Published in: BMC Musculoskeletal Disorders / Issue 1/2023
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-023-06715-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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