Risk factors related to failure of internal fixation for intertrochanteric fracture in Chinese patients: a meta analysis and review
10.3760/cma.j.issn.1671-7600.2017.05.003
- VernacularTitle:国人股骨转子间骨折术后内固定失败因素的Meta分析
- Author:
Xiaojian WANG
;
Yunxing SU
;
Jiefu SONG
;
Xiusheng GUO
;
Fang LIU
;
Zhihua ZHANG
;
Lei WEI
- Keywords:
Hip fractures;
Fracture fixation,internal;
Treatment failure;
Meta-analysis
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(5):377-386
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the risk factors related to the failure of internal fixation for intertrochanteric fracture in Chinese patients.Methods A comprehensive Meta analysis of the clinical research from January 2005 to August 2016 on the failure of internal fixation for intertrochanteric fracture in Chinese patients was conducted after Pubmed,CNKI,Wanfang Data,et al.,had been searched.Revman5.0 was used to perform the heterogeneity test and calculate the OR value and 95% CI after quality assessment and retrieval of the qualified data.Results Included for this analysis were 23 studies involving 4,031 patients of whom 588 failed.The factors related to the failure of internal fixation for intertrochanteric fracture included patient age [OR =0.51,95% CI (0.30,0.90),P < 0.05],osteoporosis [OR =1.91,95% CI (1.05,3.47),P <0.05],fracture pattern[OR=0.23,95% CI (0.18,0.30),P <0.05],quality of fracture reduction [OR =0.25,95% CI (0.17,0.35),P <0.05],tip-apex distance (TAD) [OR =0.13,95% CI (0.05,0.32),P <0.05],time for full weight bearing [OR=5.32,95% CI (1.71,16.57),P < 0.05],and associated internal diseases [OR =3.76,95% CI (1.19,11.91),P <0.05].The relationship was not determined between the failure of internal fixation for intertrochanteric fracture and the following factors:gender [OR=0.78,95% CI (0.54,1.11),P > 0.05],injury cause [OR=1.68,95% CI (0.66,4.25),P> 0.05] or type of internal fixation [OR=0.37,95%CI (0.06,2.14),P>0.05].Conclusions High age,concomitant osteoporosis,complicated fracture pattern,unsatisfactory fracture reduction,TAD ≥ 25 mm,time for full weight bearing < 6 weeks,and concomitant internal diseases may be the risk factors closely related to the failure of internal fixation for intertrochanteric fracture in Chinese patients.There has been no sufficient evidence to show that gender,injury cause or type of internal fixation may be associated with the failed internal fixation for intertrochanteric fracture.