Wu-Bin Shu1, Xiao-Bo Zhang1, Hua-Ya Lu1, He-Hui Wang1, Guan-Hua Lan2. 1. Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo Zhejiang, 315100, China. 2. Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo Zhejiang, 315100, China. Electronic address: languanhua@126.com.
Abstract
PURPOSE: The optimal internal fixation device for unstable intertrochanteric fracture remains a matter of controversy. By performing network meta-analysis, we developed a ranking of the following four surgical methods: proximal femoral nail antirotation, InterTan nail, gamma nail (GN) and sliding hip screws. We compare the complication rates in patients with unstable intertrochanteric fractures. MATERIALS AND METHODS: After an exhaustive search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials for relevant studies, randomized controlled trials meeting selection criteria were entered into our network meta-analysis. Statistical analyses were conducted using Stata software, version 13.0 (Stata Corporation, College Station, Texas, USA). RESULTS: We included 12 randomized controlled trials. Compared to Sliding hip screw, there were no substantial differences in rates of complications in unstable intertrochanteric fractures patient undergoing various treatments (all p > 0.05). Nevertheless, the surface under the cumulative ranking curve (SUCRA) for GN (80.6%) was significantly higher than those of the other three methods. CONCLUSION: GN had the highest probability of reducing the total incidence of complications among the four interventions for treating unstable intertrochanteric fractures.
PURPOSE: The optimal internal fixation device for unstable intertrochanteric fracture remains a matter of controversy. By performing network meta-analysis, we developed a ranking of the following four surgical methods: proximal femoral nail antirotation, InterTan nail, gamma nail (GN) and sliding hip screws. We compare the complication rates in patients with unstable intertrochanteric fractures. MATERIALS AND METHODS: After an exhaustive search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials for relevant studies, randomized controlled trials meeting selection criteria were entered into our network meta-analysis. Statistical analyses were conducted using Stata software, version 13.0 (Stata Corporation, College Station, Texas, USA). RESULTS: We included 12 randomized controlled trials. Compared to Sliding hip screw, there were no substantial differences in rates of complications in unstable intertrochanteric fracturespatient undergoing various treatments (all p > 0.05). Nevertheless, the surface under the cumulative ranking curve (SUCRA) for GN (80.6%) was significantly higher than those of the other three methods. CONCLUSION:GN had the highest probability of reducing the total incidence of complications among the four interventions for treating unstable intertrochanteric fractures.
Authors: Mohamed Shawky El Madboh; Lotfy Mohamed Abd ElKader Yonis; Ibrahim Ali Kabbash; Ahmed Mohamed Samy; Mohamed Abd Elhamed Romeih Journal: Indian J Orthop Date: 2021-06-10 Impact factor: 1.033