Comparison of effects of four treatment methods for unstable intertrochanteric fractures: A network meta-analysis

INTERNATIONAL JOURNAL OF SURGERY

卷:60

Review

Shu, Wu-Bin¹  Zhang, Xiao-bo¹  Lu, Hua-ya¹  Wang, He-Hui¹  Lan, Guan-Hua¹ 

[1] Ningbo Yinzhou Second Hosp, Dept Orthoped, Ningbo 315100, Zhejiang, Peoples R China

关键词: Unstable femoral intertrochanteric fractures;    Proximal femoral nail antirotation;    Gamma nail;    Sliding hip screws;    InterTan nail;    Network meta-analysis;   

DOI  :  10.1016/j.ijsu.2018.11.011

来源: Elsevier

【 摘 要 】

Purpose: The optimal internal fixation device for unstable intertrochanteric fracture remains a matter of controversy. By performing network meta-analysis, we developed a ranking of the following four surgical methods: proximal femoral nail antirotation, InterTan nail, gamma nail (GN) and sliding hip screws. We compare the complication rates in patients with unstable intertrochanteric fractures. Materials and methods: After an exhaustive search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials for relevant studies, randomized controlled trials meeting selection criteria were entered into our network meta-analysis. Statistical analyses were conducted using Stata software, version 13.0 (Stata Corporation, College Station, Texas, USA). Results: We included 12 randomized controlled trials. Compared to Sliding hip screw, there were no substantial differences in rates of complications in unstable intertrochanteric fractures patient undergoing various treatments (all p > 0.05). Nevertheless, the surface under the cumulative ranking curve (SUCRA) for GN (80.6%) was significantly higher than those of the other three methods. Conclusion: GN had the highest probability of reducing the total incidence of complications among the four interventions for treating unstable intertrochanteric fractures.

【 授权许可】

Free