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International Orthopaedics
Published in: International Orthopaedics 2/2006

01-04-2006 | Original Paper

Are short femoral nails superior to the sliding hip screw? A meta-analysis of 24 studies involving 3,279 fractures

Authors: Henry Wynn Jones, Philip Johnston, Martyn Parker

Published in: International Orthopaedics | Issue 2/2006

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Abstract

The purpose of this meta-analysis was to compare the fixation outcome between the sliding hip screw (SHS) and intramedullary nails (IMN) in stable and unstable extracapsular proximal femoral fractures. All randomised controlled studies comparing IMNs with a SHS were considered for inclusion. Data was independently extracted and trial methodology assessed. Twenty-four randomised trials involving 3,202 patients with 3,279 fractures were included. Pooled results gave no statistically significant difference in the cut-out rate between the IMN and SHS (41/1,556 vs 37/1,626; relative risk 1.19; 95% confidence interval 0.78–1.82). Total failure rate (1,03/1,495 and 58/1,565, relative risk 1.83; 95% confidence interval 1.35–2.50) and re-operation rate (57/1,357 and 35/1,415, relative risk 1.63; 95% confidence interval 1.11–2.40) were greater with the IMN compared with the SHS. There was no evidence for a reduced failure rate with IMN in unstable trochanteric fractures.
Literature
1.
Adams CI, Robinson CM, Court-Brown C, McQueen MM (2001) Prospective randomised controlled trial of an intramedullary nail versus dynamic hip screw and plate for intertrochanteric fractured femur. J Orthop Trauma 15 (6):394–400CrossRefPubMed
2.
Audige L, Hanson B, Swiontkowski MF (2004) Answer to Handoll and Parker. Int Orthop 28:62–63CrossRef
3.
Audige L, Hanson B, Swiontkowski MF (2003) Implant-related complications in the treatment of unstable intertrochanteric fractures: meta-analysis of dynamic screw-plate versus dynamic screw-intramedullary nail devices. Int Orthop 27:197–203CrossRefPubMed
4.
Aune AK, Ekeland A, Odegaard B, Grogaard B, Alho A (1994) Gamma nail vs compression screw for trochanteric femoral fractures. 15 reoperations in a prospective, randomized study of 378 patients. Acta Orthop Scand 65:127–130PubMedCrossRef
5.
Baumgaertner MR, Curtin SL, Lindskog DM (1998) Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures. Clin Orthop Relat Res 348:87–94CrossRefPubMed
6.
Bridle SH, Patel AD, Bircher M, Calvert PT (1991) Fixation of intertrochanteric fractures of the femur: a randomised prospective comparison of the gamma nail and the dynamic hip screw. J Bone Joint Surg Br 73:330–334PubMed
7.
Butt MS, Krikler SJ, Nafie S, Ali MS (1995) Comparison of dynamic hip screw and gamma nail: a prospective, randomized, controlled trial. Injury 26(9):615–618CrossRefPubMed
8.
Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 52:377–384PubMedCrossRef
9.
Fornander P, Thorngren K-G, Tornqvist H, Ahrengart L, Lindgren U (1994) Swedish experience with the gamma nail vs. sliding hip screw in 209 randomised cases. International Journal of Orthopaedic Trauma 4(3):118–122
10.
Hardy DC, Descamps P, Krallis P, Fabeck L, Smets P, Bertens CL et al (1998) Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients. J Bone Joint Surg Am 80(5):618–630PubMed
11.
Harrington P, Nihal A, Singhania AK, Howell FR (2002) Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly. Injury 33(1):23–28CrossRefPubMed
12.
Hoffman CW, Lynskey TG (1996) Intertrochanteric fractures of the femur: a randomized prospective comparison of the gamma nail and the Ambi hip screw. Aust NZ J Surg 66(3):151–155CrossRef
13.
Leung KS, So WS, Shen WY, Hui PW (1992) Gamma nails and dynamic hip screws for peritrochanteric fractures. A randomised prospective study in elderly patients. J Bone Joint Surg Br 74(3):345–351PubMed
14.
Lorich DG, Geller DS, Nielson JH (2004) Osteoporotic pertrochanteric hip fractures; management and current controversies. J Bone Joint Surg Am 86:398–410
15.
O’Brien PJ, Meek RN, Blachut PA, Broekhuyse HM, Sabharwal S (1995) Fixation of intertrochanteric hip fractures: gamma nail versus dynamic hip screw. A randomised, prospective study. Can J Surg 38(6):516–520PubMed
16.
Park SR, Kang JS, Kim HS, Lee WH (1998) Treatment of intertrochanteric fracture with the gamma AP locking nail or by a compression hip screw-a randomised prospective trial. Int Orthop 22(3):157–160CrossRefPubMed
17.
Parker MJ, Pryor GA (1996) Gamma nailing verses DHS for extracapsular femoral fractures: meta-analysis of ten randomised trails. Int Orthop 20:163–168CrossRefPubMed
18.
Parker MJ (1999) Proximal Femoral Fractures. In: Pynsent PB, Fairbank JCT, Carr AJ (eds) Classification of musculoskeletal trauma, Butterworth Heinemann, Oxford
19.
Parker MJ, Handoll HHG (2004) Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures (Cochrane Review). In: The Cochrane Library, Issue 3. John Wiley & Sons, Chichester
20.
Radford PJ, Needoff M, Webb JK (1993) A prospective randomised comparison of the dynamic hip screw and the gamma locking nail. J Bone Joint Surg Br 75(5):789–793PubMed
21.
Sadowski C, Lubbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P (2002) Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degree screw-plate. J Bone Joint Surg Am 84(3):372–381PubMed
22.
Saudan M, Lubbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P (2002) Pertrochanteric fractures: is there an advantage to an intramedullary nail? A randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma 16(6):386–393CrossRefPubMed
23.
Schipper IB, Marti RK, van der Werken C (2004) Unstable trochanteric femoral fractures: extramedullary or intramedullary fixation review of literature. Injury 35:141–151CrossRef
24.
Schipper IB, Steyerberg EW, Castelein RM, van der Heijden FHWM, den Hoed PT, Kerver AJH, van Vugt AB (2004) Treatment of unstable trochanteric fractures: randomised comparison of the gamma nail and the Proximal Femoral Nail. J Bone Joint Surg Br 86:86–94PubMed
Metadata
Title
Are short femoral nails superior to the sliding hip screw? A meta-analysis of 24 studies involving 3,279 fractures
Authors
Henry Wynn Jones
Philip Johnston
Martyn Parker
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 2/2006
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-005-0028-0

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