Anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures: A Meta-analysis

Abstract

Abstract:

BACKGROUND: There is no consensus on the choice of anatomic plate or dynamic hip screw for the treatment of intertrochanteric fracture. Current research is limited to small-sample studies, and it is difficult to carry out a large-sample multicenter analysis.
OBJECTIVE: To carry out Meta-analysis about the literature on anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures, in order to evaluate the efficacy of anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures.
METHODS: The PubMed database (1995-2013), EMCC database (1995-2013), CBM database (1995-2013), CNKI database (1995-2013), VIP database (1989-2013) and Wanfang database (1995-2013) were searched by computer to collect the controlled trials of anatomic plate versus dynamic hip screw for the treatment of intertrochanteric fractures. Then, the retrieved studies were screened according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated to extract usefully data, and Meta-analysis was performed by using the RevMan5.0 software.
RESULTS AND CONCLUSION: A total of 19 controlled trials were included with a total of 1 730 cases. Among them, 764 cases were belonged to the anatomic plate group, and dynamic hip screw group included 966 cases. The Meta-analysis results indicated that there were no statistically significant differences in fracture healing time, prognosis excellent and good rate and postoperative complications between two groups (P=0.34, 0.58, 0.80); the operative time, intraoperative blood loss and postoperative drainage volume in the anatomic plate group were lower than those in the dynamic hip screw group (P < 0.000 01). The results indicate that anatomic plate and dynamic hip screw have the similar clinical efficacy for the treatment of intertrochanteric fractures, but the anatomical plate has relatively simple operation and less bleeding. Due to the poor quality of the included literatures and high bias occur and influence the effect, so more well-designed multi-center randomized controlled trials should be performed to provide high-quality evidence.

Key words: hip fractures, femoral fractures, Meta-agalysis, evidence-based medicine

CLC Number:

R318

Ma Hong-liang, Peng Jun, Chen Yi. Anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures: A Meta-analysis[J]. Chinese Journal of Tissue Engineering Research.

Figures/Tables 5

References

[1]        Laohapoonrungsee A, Arpornchayanon O, Phornputkul C. Two-hole side-plate DHS in the treatment of intertrochanteric fracture: results and complications. Injury. 2005;36(11): 1355-1360.
[2]        Bienkowski P, Reindl R, Berry GK, et al. A new intramedullary nail device for the treatment of intertrochanteric hip fractures: Perioperative experience. J Trauma. 2006;61(6):1458-1462.
[3]        Fox KM, Magaziner J, Hawkes WG, et al. Loss of bone density and lean body mass after hip fracture. Osteoporos Int. 2000;11(1):31-35.
[4]        周国强. 解剖型钢板与动力髋螺钉治疗老年股骨粗隆间骨折的对比分析[J].临床和实验医学杂志,2011,16(10):1279-1280.
[5]        赵勇刚. 解剖型钢板与DHS治疗老年股骨粗隆间骨折的效果比较[J]. 中国医学创新,2011,23(8): 37-38.
[6]        韩亮. 三种固定方法治疗股骨粗隆间骨折98例分析比较[J].中国保健营养,2012,(11):395-396.
[7]        薛春堂,郝鸿伟,刘敬,等. 老年人股骨粗隆间骨折109例手术疗效分析[J]. 陕西医学杂志,2010, 39(7):844-845.
[8]        郭世明,丁真奇,洪加源,等.3种内固定方法治疗老年股骨粗隆间骨折的病例对照研究[J].中国骨伤,2012,25(6):474-477.
[9]        夏广春.老年股骨粗隆问骨折两种内固定方式疗效分析[J].中国当代医药,2011,18(15):152,155.
[10]     高斌. 老年股骨粗隆间骨折不同内固定治疗疗效观察[J].四川医学,2012,33(1):80-82.
[11]     杜一鑫,陈国富.解剖型钢板与动力髋螺钉治疗老年股骨粗隆问骨折的疗效对比[J].中国现代医生, 2011,49(7):84-85.
[12]     蓝子江,龚志峰,沈光程,等.解剖型钢板与动力髋螺钉治疗老年股骨粗隆间骨折的疗效比较[J].中国药物与临床,2012, 12(4): 480-481.
[13]     贝朝涌,林卓锋,杨志,等. 解剖型钢板与动力髋螺钉治疗老龄股骨粗隆间骨折的疗效比较[J].广西医科大学学报,2008,25(4): 575-577.
[14]     刘忠,张卫兵,柴林涛,等.股骨粗隆间骨折手术治疗86例临床分析[J].解剖与临床,2008,13(4): 300-301.
[15]     吕静,李玉龙,席剑,等.股骨粗隆间骨折钢板内固定的应用研究[J].中国医药指南,2011,9(31):6-8.
[16]     王鲁,李长德,臧志海,等.动力髋螺钉和解剖型钢板治疗股骨粗隆间骨折比较[J].中国老年学杂志,2010,30(21):3195-3196.
[17]     宋锡伦,唐广应,苏军,等.动力髋螺钉、解剖型钢板及中空螺钉治疗股骨粗隆间骨折的疗效分析[J].中国骨与关节损伤杂志,2006, 21(1):58-59.
[18]     崔风国,宋维,丛皎,等. 不同方法治疗老年性股骨粗隆间骨折的临床分析[J]. 国际外科学杂志,2010,37(6):372-374.
[19]     王凯,车彪,邹凯,等. DHS合并加压螺钉在股骨粗隆间骨折中应用的疗效分析[J].中国矫形外科杂志,2008,16(16): 1210-1211, 1220.
[20]     叶茂,李俊清,王建国,等. 股骨转子间骨折的手术治疗分析[J].中国骨伤,2007,20(3):170-172.
[21]     申明高,郑文哥,谢彪,等. 中老年股骨转子间骨折几种治疗方法疗效分析[J]. 医学信息,2009,1(5): 215.
[22]     袁景.不同方法治疗老年股骨转子间骨折的疗效分析[J].临床骨科杂志,2010,13(2):224-225.
[23]     Takigami I, Matsumoto K, Ohara A,et al. Treatment of trochanteric fractures with the PFNA (proximal femoral nail antirotation) nail system - report of early results. Bull NYU Hosp Jt Dis. 2008;66(4):276-279.
[24]     Alobaid A, Harvey EJ, Elder GM,et al. Minimally invasive dynamic hip screw: prospective randomized trial of two techniques of insertion of a standard dynamic fixation device. J Orthop Trauma. 2004;18(4):207-212.