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12 September 2014 : Original article  

Proximal Femoral Nail vs. Dynamic Hip Screw in Treatment of Intertrochanteric Fractures: A Meta-Analysis

Kairui ZhangAC, Sheng ZhangAC, Jun YangB, Weiqiang DongB, Shengnan WangB, Yirong ChengF, Mohammed Al-QwbaniD, Qiang WangA, Bin YuA

DOI: 10.12659/MSM.890962

Med Sci Monit 2014; 20:1628-1633

Abstract

BACKGROUND: The aim of this meta-analysis was to compare the outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures.

MATERIAL AND METHODS: Relevant randomized or quasi-randomized controlled studies comparing the effects of PFN and DHS were searched for following the requirements of the Cochrane Library Handbook. Six eligible studies involving 669 fractures were included. Their methodological quality was assessed and data were extracted independently for meta-analysis.

RESULTS: The results showed that the PFN group had significantly less operative time (WMD: –21.15, 95% CI: –34.91 – –7.39, P=0.003), intraoperative blood loss (WMD: –139.81, 95% CI: –210.39 – –69.22, P=0.0001), and length of incision (WMD: –6.97, 95% CI: –9.19 – –4.74, P<0.00001) than the DHS group. No significant differences were found between the 2 groups regarding postoperative infection rate, lag screw cut-out rate, or reoperation rate.

CONCLUSIONS: The current evidence indicates that PFN may be a better choice than DHS in the treatment of intertrochanteric fractures.

Keywords: Aged, 80 and over, Blood Loss, Surgical, Bone Nails, Bone Screws, Femur - surgery, Hip Fractures - surgery, operative time, Postoperative Complications - etiology, Reoperation

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750