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    Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence

    239431_239431.pdf (731.9Kb)
    Access Status
    Open access
    Authors
    Yu, J.
    Zhang, Chao
    Li, Ling
    Kwong, J.
    Xue, L.
    Zeng, X.
    Tang, Li
    Li, Y.
    Sun, X.
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Yu, J. and Zhang, C. and Li, L. and Kwong, J. and Xue, L. and Zeng, X. and Tang, L. et al. 2015. Internal fixation treatments for intertrochanteric fracture: A systematic review and meta-Analysis of randomized evidence. Scientific Reports. 5: Article ID 18195.
    Source Title
    Scientific Reports
    DOI
    10.1038/srep18195
    School
    Department of Civil Engineering
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/

    URI
    http://hdl.handle.net/20.500.11937/25782
    Collection
    • Curtin Research Publications
    Abstract

    The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain uncertain. We conducted a systematic review and meta-Analysis of randomized controlled trials (RCTs) to address this important issue. We searched PubMed, EMBASE and CENTRAL for RCTs that compared different internal fixation implants in patients with intertrochanteric fracture at 6-month follow-up or longer. We ultimately included 43 trials enrolling 6911 patients; most trials were small in sample sizes and events. Their risk of bias was generally unclear due to insufficient reporting. Because of these, no statistically significant differences were present from most of the comparisons across all the outcomes, and no definitive conclusions can be made. However, a number of trials compared two commonly used internal fixation strategies, gamma nail (GN) and sliding hip screw (SHS). There is good evidence suggesting that, compared to SHS, GN may increase the risk of cut out (OR = 1.87, 95% CI, 1.08 to 3.21), re-operation (OR = 1.61, 95% CI, 1.02 to 2.53), intra-operative (OR = 3.14, 95% CI, 1.34 to 7.35) and later fractures (OR = 3.67, 95% CI, 1.37 to 9.83). Future randomized trials or observational studies that are carefully designed and conducted are warranted to establish the effects of alternative internal fixation strategies for intertrochanteric fracture.

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