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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2017

Open Access 01-12-2017 | Research article

Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis

Authors: Feng-Jen Tseng, Wei-Tso Chia, Ru-Yu Pan, Leou-Chyr Lin, Hsian-Chung Shen, Chih-Hung Wang, Jia-Fwu Shyu, Ching-Feng Weng

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

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Abstract

Background

This meta-analysis compared clinical outcomes of arthroplasty vs. osteosynthesis for displaced femoral neck fractures.

Methods

Meta-analysis was performed on the difference in revision rate and overall mortality between participants undergoing osteosynthesis vs. total hip arthroplasty (THA), osteosynthesis vs. hemiarthroplasty (HA), or THA vs. HA.

Results

Pooled direct and indirect results indicated no significant difference in mortality between THA and HA (pooled OR = 0.87, 95% CI 0.55 to 1.38; P = 0.556), between THA and osteosynthesis (pooled OR = 1.17, 95% CI 0.69 to 1.99; P = 0.553), and between HA and osteosynthesis (pooled OR = 1.21, 95% CI 0.84 to 1.74; P = 0.304). Pooled direct and indirect results indicated no significant difference in revision rates between THA and HA (pooled OR = 0.90, 95% CI 0.26 to 3.19; P = 0.874). But, fewer revisions (OR = 0.19, 95% CI 0.10 to 0.34; P = 0.000) were seen in patients treated with THA than osteosynthesis and also in those treated with HA than osteosynthesis (OR = 0.12, 95% CI 0.07 to 0.20; P = 0.000). After excluding studies without showing normal cognition in inclusion criteria, pooled direct and indirect results also indicated no significant difference in mortality between THA, HA, and osteosynthesis. Similarly, there was no significant difference in revision rates between THA and HA, but HA and THA had significantly lower revision rates compared with osteosynthesis.

Conclusions

There was no significant difference in overall mortality among osteosynthesis, HA, and THA. However, HA and THA had significantly lower revision rates compared with osteosynthesis. Results of the present study provide support for the use of hip arthroplasty to treat displaced fractures of the femoral neck.
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Metadata
Title
Comparison of arthroplasty vs. osteosynthesis for displaced femoral neck fractures: a meta-analysis
Authors
Feng-Jen Tseng
Wei-Tso Chia
Ru-Yu Pan
Leou-Chyr Lin
Hsian-Chung Shen
Chih-Hung Wang
Jia-Fwu Shyu
Ching-Feng Weng
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0629-5

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