Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (9): 1656-1660.doi: 10.3969/j.issn.1673-8225.2012.09.032

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Systematic review of arthroplasty combined with internal fixation for displaced femoral neck fractures in elderly patients 

Chen Yue-ping1, Gao Hui1,Chen Liang1, Luo Dong-fang1, Yin Qing-shui2   

  1. 1Department of Orthopedics, Affiliated Rui Kang Hospital of Guangxi Traditional Chinese Medical School, Nanning  530011, Guangxi Zhuang Autonomous Region, China2Orthopaedic Hospital, People's Liberation Army General Hospital of Guangzhou Military Command, Guangzhou  510010, Guangdong Province, China
  • Received:2011-09-01 Revised:2011-10-18 Online:2012-02-26 Published:2012-02-26
  • About author:Chen Yue-ping☆, Studying for doctorate, Associate chief physician, Associate professor, Master’s supervisor, Department of Orthopedics, Affiliated Rui Kang Hospital of Guangxi Traditional Chinese Medical School, Nanning 530011, Guangxi Zhuang Autonomous Region, China chenyueping007@126.com

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Abstract:

BACKGROUND: Treatment of femoral neck fracture in elderly patients is always through internal fixation or arthroplasty, but how to choose the two procedures for the treatment is the debate focus of orthopedic surgeons.
OBJECTIVE: To review the clinical outcomes and safety between arthroplasty and internal fixation in treatment of elderly patients with femoral neck fracture.
METHODS: Cochrane central register of controlled trials (fifth book in 2011), MEDLINE (1966-01/2011-05), EMbase (1984-01/2011-05) and CNKI (1979-01/2011-05) were (> 60 years) searched. Only randomized clinical trials that compared arthroplasty with internal fixation for the treatment of femoral neck fracture in the elderly (>60 years) were included. The analysis was performed with software RevMan5.1.2 from the Cochrane collaboration. The study was rated by GRADEpro version3.2.2 Software.
RESULTS AND CONCLUSION: There were 87 potentially relevant papers and 13 published studies met all the inclusion criteria and proved eligible for this investigation at last. A total of 2 436 patients were included. The meta-analysis showed there was no significant difference of the mortality between the arthroplasty group and the internal fixation group at 2, 10 or over 10 years follow-up. Reoperation rate and surgical complication at 2, 10 or over 10 years follow-up in the arthroplasty group were significantly lower than those of the internal fixation group. It is indicated that whether short or long-term option arthroplasty for displaced femoral neck fractures in the elderly can significantly reduce the reoperation rate and major complications.

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