Abstract
In this network meta-analysis, we determined the optimal surgical method for treating unstable femoral intertrochanteric fractures. We searched the EMBASE, Cochrane Library and Medline databases for studies evaluating sliding hip screws (SHS), gamma nail (GN) or proximal femoral nail antirotation (PFNA) methods, and included nine randomized controlled trials that met the inclusion criteria. Our analysis showed no differences in the rates of complications between SHS and PFNA relative to GN (p > 0.05). However, the surface under the cumulative ranking curve (SUCRA) score for PFNA (77.6%) was higher than the SUCRA scores for GN (65%) and SHS (7.5%). This suggests PFNA is the better surgical method than GN or SHS for unstable femoral intertrochanteric fractures.
Highlights
Femoral intertrochanteric fracture is a common hip fracture that occurs in the elderly [1, 2]
We identified 3,109 records by searching MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases using search parameters listed in Supplementary List 1
It was composed of a single triangular gamma nail (GN) - proximal femoral nail antirotation (PFNA)- sliding hip screws (SHS) loop with a 95% confidence interval (95% CI) (IF) value of zero, which demonstrates that our network analysis data was consistent
Summary
Femoral intertrochanteric fracture is a common hip fracture that occurs in the elderly [1, 2]. The sliding hip screw (SHS) is the gold standard technique for treating stable femoral intertrochanteric fractures, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association-31 A1 (AO/OTA 31–A1) [4,5,6]. The optimal treatment method for treating unstable femoral intertrochanteric fractures such as AO/ OTA 31-A2 and AO/OTA 31–A3 is controversial. The common treatment methods are proximal femoral nail antirotation (PFNA), gamma nail (GN), and sliding hip screws (SHS). Traditional meta-analyses are inconclusive in determining the best method for treating unstable femoral intertrochanteric fractures because they cannot accurately evaluate 3 or more interventions [7,8,9]. We performed a network meta-analysis to determine the optimal treatment method for unstable femoral intertrochanteric fractures based on evaluating the rates of complications between GN, PFNA and SHS
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call