Hip arthroplasty versus internal fixation for displaced femoral neck fractures in the elderly patients: a Meta-analysis
10.3760/cma.j.issn.1671-7600.2014.02.005
- VernacularTitle:髋关节置换与内固定术治疗老年移位型股骨颈骨折术后再手术率和并发症的系统评价
- Author:
Zhenhui SUN
;
Yueju LIU
;
Heng LI
- Publication Type:Journal Article
- Keywords:
Femoral neck fractures;
Arthroplasty,replacement,hip;
Fracture fixation,internal;
Meta-analysis
- From:
Chinese Journal of Orthopaedic Trauma
2014;16(2):115-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare hip arthroplasty versus internal fixation for treatment of displaced femoral neck fractures in the elderly patients in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.Methods All the randomized controlled trials (RCTs) up to May 2013 on hip arthroplasty versus internal fixation for displaced femoral neck fractures in the elderly were electronically searched for in Pubmed/Medline,EMBASE,Cochrane CENTRAL,CNKI,WanFang and VIP databases.The 2 treatments were compared in terms of reoperation,surgery-related complications and postoperative 1-2-year mortality.The Meta analysis was performed with RevMan 5.2.5 software.Results Five eligible RCTs involving 1 288 cases were included for this review.The rate of reoperation (including implant removal and other operations),either within 2 years or over 2 years,in the internal fixation group was significantly higher than that in the arthroplasty group (P ＜ 0.05).The surgery-related complications in the internal fixation group was significantly higher than that in the hip arthroplasty group [OR =8.82,95％ CI (6.45,12.07),P ＜0.001].No significant difference was found in the postoperative 1-2-year mortality between the 2 groups (P ＞0.05).Conclusion In the treatment of displaced femoral neck fractures in the elderly,compared with internal fixation,arthroplasty should be recommended as the first choice,because it can significantly reduce surgery-related complications and reoperations though it cannot decrease the postoperative 1-2-year mortality.
