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Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis
OBJECTIVE: This systematic review and meta-analysis compared extramedullary fixation and intramedullary fixation for stable two-part trochanteric femoral fractures (AO type 31-A1) with regards to functional outcomes, complications, and surgical outcomes. METHODS: Embase, Medline, Web of Science, Coc...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374813/ https://www.ncbi.nlm.nih.gov/pubmed/37129692 http://dx.doi.org/10.1007/s00402-023-04902-1 |
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author | Zeelenberg, Miliaan L. Nugteren, Leendert H. T. Plaisier, A. Cornelis Loggers, Sverre A. I. Joosse, Pieter Den Hartog, Dennis Verhofstad, Michael H. J. van Lieshout, Esther M. M. |
author_facet | Zeelenberg, Miliaan L. Nugteren, Leendert H. T. Plaisier, A. Cornelis Loggers, Sverre A. I. Joosse, Pieter Den Hartog, Dennis Verhofstad, Michael H. J. van Lieshout, Esther M. M. |
author_sort | Zeelenberg, Miliaan L. |
collection | PubMed |
description | OBJECTIVE: This systematic review and meta-analysis compared extramedullary fixation and intramedullary fixation for stable two-part trochanteric femoral fractures (AO type 31-A1) with regards to functional outcomes, complications, and surgical outcomes. METHODS: Embase, Medline, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar were searched for randomized controlled trials (RCTs) and observational studies. Effect estimates were pooled across studies using random effects models. Results were presented as weighted risk ratio (RR) or weighted mean difference (MD) with corresponding 95% confidence interval (95% CI). RESULTS: Five RCTs (397 patients) and 14 observational studies (21,396 patients) were included. No significant differences in functional outcomes, complications, or surgical outcomes were found between extramedullary and intramedullary fixation devices, except for a difference in duration of surgery (MD 14.1 min, CI 5.76–22.33, p < 0.001) and intra-operative blood loss (MD 92.30 mL, CI 13.49–171.12, p = 0.02), favoring intramedullary fixation. CONCLUSION: Current literature shows no meaningful differences in complications, surgical, or functional outcomes between extramedullary and intramedullary fixation of stable two-part trochanteric femoral fractures. Both treatment options result in good outcomes. This study implicates that, costs should be taken into account when considering implants or comparing fixation methods in future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00402-023-04902-1. |
format | Online Article Text |
id | pubmed-10374813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-103748132023-07-29 Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis Zeelenberg, Miliaan L. Nugteren, Leendert H. T. Plaisier, A. Cornelis Loggers, Sverre A. I. Joosse, Pieter Den Hartog, Dennis Verhofstad, Michael H. J. van Lieshout, Esther M. M. Arch Orthop Trauma Surg Trauma Surgery OBJECTIVE: This systematic review and meta-analysis compared extramedullary fixation and intramedullary fixation for stable two-part trochanteric femoral fractures (AO type 31-A1) with regards to functional outcomes, complications, and surgical outcomes. METHODS: Embase, Medline, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar were searched for randomized controlled trials (RCTs) and observational studies. Effect estimates were pooled across studies using random effects models. Results were presented as weighted risk ratio (RR) or weighted mean difference (MD) with corresponding 95% confidence interval (95% CI). RESULTS: Five RCTs (397 patients) and 14 observational studies (21,396 patients) were included. No significant differences in functional outcomes, complications, or surgical outcomes were found between extramedullary and intramedullary fixation devices, except for a difference in duration of surgery (MD 14.1 min, CI 5.76–22.33, p < 0.001) and intra-operative blood loss (MD 92.30 mL, CI 13.49–171.12, p = 0.02), favoring intramedullary fixation. CONCLUSION: Current literature shows no meaningful differences in complications, surgical, or functional outcomes between extramedullary and intramedullary fixation of stable two-part trochanteric femoral fractures. Both treatment options result in good outcomes. This study implicates that, costs should be taken into account when considering implants or comparing fixation methods in future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00402-023-04902-1. Springer Berlin Heidelberg 2023-05-02 2023 /pmc/articles/PMC10374813/ /pubmed/37129692 http://dx.doi.org/10.1007/s00402-023-04902-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Trauma Surgery Zeelenberg, Miliaan L. Nugteren, Leendert H. T. Plaisier, A. Cornelis Loggers, Sverre A. I. Joosse, Pieter Den Hartog, Dennis Verhofstad, Michael H. J. van Lieshout, Esther M. M. Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title | Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title_full | Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title_fullStr | Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title_full_unstemmed | Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title_short | Extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
title_sort | extramedullary versus intramedullary fixation of stable trochanteric femoral fractures: a systematic review and meta-analysis |
topic | Trauma Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374813/ https://www.ncbi.nlm.nih.gov/pubmed/37129692 http://dx.doi.org/10.1007/s00402-023-04902-1 |
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