Cargando…

Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)

BACKGROUND: The purpose of this meta-analysis was to evaluate the clinical efficacy and safety of HR and PFNA in the treatment of intertrochanteric fractures in the elderly. METHODS: We carried out this review according to the principle of preferred reporting items for systematic reviews and meta-an...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Junming, Yue, Chen, He, Peilin, Huang, Zeling, Li, Li, Zhang, Xue, Fan, Yanan, Liu, Youwen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939162/
https://www.ncbi.nlm.nih.gov/pubmed/33655910
http://dx.doi.org/10.1097/MD.0000000000024166
_version_ 1783661693450059776
author Chen, Junming
Yue, Chen
He, Peilin
Huang, Zeling
Li, Li
Zhang, Xue
Fan, Yanan
Liu, Youwen
author_facet Chen, Junming
Yue, Chen
He, Peilin
Huang, Zeling
Li, Li
Zhang, Xue
Fan, Yanan
Liu, Youwen
author_sort Chen, Junming
collection PubMed
description BACKGROUND: The purpose of this meta-analysis was to evaluate the clinical efficacy and safety of HR and PFNA in the treatment of intertrochanteric fractures in the elderly. METHODS: We carried out this review according to the principle of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline. The clinical randomized controlled trials (RCTs), prospective cohort studies, retrospective cohort studies (RCSs), and case-control studies involving HR and PFNA in the treatment of intertrochanteric fractures in the elderly from 2000 to 2020 were compared by searching Web of Science, Pubmed, the Cochrane Library, and Embase. The quality of the included cohort study (CS) lines was evaluated using the Newcastle-Ottawa Scale (NOS). The quality of the included RCT lines was evaluated using Jadad. Forest plots were drawn by RevMan5.4 software based on the results and the data were analyzed. RESULTS: After screening, a total of 9 articles were included, of which one was a clinical RCT and eight were RCSs with 1374 patients. The operative time of the PFNA group was shorter [WMD = 15.20; 95% CI (13.17, 17.23), P < .05] and the intraoperative blood loss was less [WMD = 178.81; 95% CI (97.24, 260.38), P < .05] than the HR group, while the first weight-bearing time of the HR group was shorter [WMD = −7.70; 95% CI (−10.54, −4.86), P < .05] than the PFNA group. There was no significant difference in the length of hospital stay, HHS, postoperative orthopedic complications, and postoperative medical complications between the 2 groups. CONCLUSION: With the development of HR technology and minimally invasive technology, the trauma caused by surgery is decreasing. Under the premise of improving perioperative management, such as optimizing the preoperative preparation and postoperative management, shortening the operative time, reducing intraoperative blood loss, and actively managing co-existing diseases, HR has more advantages than PFNA in the treatment of senile intertrochanteric fractures.
format Online
Article
Text
id pubmed-7939162
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-79391622021-03-08 Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA) Chen, Junming Yue, Chen He, Peilin Huang, Zeling Li, Li Zhang, Xue Fan, Yanan Liu, Youwen Medicine (Baltimore) 7100 BACKGROUND: The purpose of this meta-analysis was to evaluate the clinical efficacy and safety of HR and PFNA in the treatment of intertrochanteric fractures in the elderly. METHODS: We carried out this review according to the principle of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline. The clinical randomized controlled trials (RCTs), prospective cohort studies, retrospective cohort studies (RCSs), and case-control studies involving HR and PFNA in the treatment of intertrochanteric fractures in the elderly from 2000 to 2020 were compared by searching Web of Science, Pubmed, the Cochrane Library, and Embase. The quality of the included cohort study (CS) lines was evaluated using the Newcastle-Ottawa Scale (NOS). The quality of the included RCT lines was evaluated using Jadad. Forest plots were drawn by RevMan5.4 software based on the results and the data were analyzed. RESULTS: After screening, a total of 9 articles were included, of which one was a clinical RCT and eight were RCSs with 1374 patients. The operative time of the PFNA group was shorter [WMD = 15.20; 95% CI (13.17, 17.23), P < .05] and the intraoperative blood loss was less [WMD = 178.81; 95% CI (97.24, 260.38), P < .05] than the HR group, while the first weight-bearing time of the HR group was shorter [WMD = −7.70; 95% CI (−10.54, −4.86), P < .05] than the PFNA group. There was no significant difference in the length of hospital stay, HHS, postoperative orthopedic complications, and postoperative medical complications between the 2 groups. CONCLUSION: With the development of HR technology and minimally invasive technology, the trauma caused by surgery is decreasing. Under the premise of improving perioperative management, such as optimizing the preoperative preparation and postoperative management, shortening the operative time, reducing intraoperative blood loss, and actively managing co-existing diseases, HR has more advantages than PFNA in the treatment of senile intertrochanteric fractures. Lippincott Williams & Wilkins 2021-03-05 /pmc/articles/PMC7939162/ /pubmed/33655910 http://dx.doi.org/10.1097/MD.0000000000024166 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 7100
Chen, Junming
Yue, Chen
He, Peilin
Huang, Zeling
Li, Li
Zhang, Xue
Fan, Yanan
Liu, Youwen
Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title_full Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title_fullStr Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title_full_unstemmed Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title_short Comparison of clinical outcomes with hip replacement versus PFNA in the treatment of intertrochanteric fractures in the elderly: A systematic review and meta-analysis (PRISMA)
title_sort comparison of clinical outcomes with hip replacement versus pfna in the treatment of intertrochanteric fractures in the elderly: a systematic review and meta-analysis (prisma)
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939162/
https://www.ncbi.nlm.nih.gov/pubmed/33655910
http://dx.doi.org/10.1097/MD.0000000000024166
work_keys_str_mv AT chenjunming comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT yuechen comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT hepeilin comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT huangzeling comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT lili comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT zhangxue comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT fanyanan comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma
AT liuyouwen comparisonofclinicaloutcomeswithhipreplacementversuspfnainthetreatmentofintertrochantericfracturesintheelderlyasystematicreviewandmetaanalysisprisma