机构：[1]Department of Orthopedics & Microsurgery, Guangdong Second Provincial General Hospital,[2]Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou,[3]Department of Orthopedics, Hubei traditional Chinese Medicine University Affiliated Hospital of Xiangyang traditional Chinese Medicine hospital, Xiangyang,[4]Physical Examination Center, Aerospace Central Hospital, Beijing, China.
To find out whether the intramedullary fixations are superior to the extramedullary fixations in treating unstable femoral intertrochanteric fractures (UFIFs).
The meta-analysis of randomized controlled trials (RCTs) was conducted by searching the PubMed, Cochrane Library, and Embase databases to evaluate functional scores, surgical outcomes, and adverse events in adult patients receiving intramedullary fixations in comparison to extramedullary fixations. Risk ratio (RR) or weighted mean difference (WMD)/standard mean difference (SMD) with 95% confidence intervals (CIs) were calculated as effect sizes.
A total of 18 RCTs, comprising 2414 patients, were included in this meta-analysis. Primary efficacy outcome: Parker scores [weighted mean difference, 1.10, 95% confidence interval (CI), 0.64-1.55; P < .0001] and Harris hip scores [risk ratio, 1.24, 95%CI, 1.09 -1.41; P = .0008] were higher in the intramedullary fixation group. Moreover, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group. Other secondary efficacy outcome: No significant differences were found between the 2 groups in terms of fluoroscopy time, mortality, cut-out, nonunion, superficial wound infection, later fracture, and reoperation.
This meta-analysis suggested that intramedullary fixation is more effective and safer than extramedullary fixation in treating UFIFs. Furthermore, blood loss, operative time, length of incision, hospital stay, and implant failure were superior in the intramedullary fixation group.
基金：
Science Foundation of Guangdong No. 2
Provincial People’s Hospital (YQ2015–006).
第一作者机构：[1]Department of Orthopedics & Microsurgery, Guangdong Second Provincial General Hospital,[2]Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou,[*1]Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510665, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Orthopedics & Microsurgery, Guangdong Second Provincial General Hospital,[2]Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou,[*1]Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510665, China
推荐引用方式(GB/T 7714)：
Sun Dawei,Wang Chunling,Chen Yuhui,et al.A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures.[J].MEDICINE.2019,98(37):doi:10.1097/MD.0000000000017010.
APA：
Sun Dawei,Wang Chunling,Chen Yuhui,Liu Xiaochun,Zhao Peng...&Qin Chenghe.(2019).A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures..MEDICINE,98,(37)
MLA：
Sun Dawei,et al."A meta-analysis comparing intramedullary with extramedullary fixations for unstable femoral intertrochanteric fractures.".MEDICINE 98..37(2019)
