Comparative effectiveness research on proximal femoral nail versus dynamic hip screw in patients with trochanteric fractures: a systematic review and meta-analysis of randomized trials

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dc.contributor.authorXu, Hong
dc.contributor.authorLiu, Yang
dc.contributor.authorSezgin, Erdem Aras
dc.contributor.authorTarasevicius, Sarunas
dc.contributor.authorChristensen, Robin
dc.contributor.authorRaina, Deepak Bushan
dc.contributor.authorTagil, Magnus
dc.contributor.authorLidgren, Lars
dc.date.accessioned2022-06-27T06:28:37Z
dc.date.available2022-06-27T06:28:37Z
dc.date.issued2022
dc.departmentTıp Fakültesi
dc.description.abstractBackground The treatments for trochanteric fractures try to regain early mobility and limit morbidity and risk of reoperations. The most currently used dynamic hip screw (DHS) and the proximal femoral nail (PFN) are both with pros and cons. We aimed to assess the comparative effectiveness of these interventions for trochanteric fractures by evaluating the surgical performance and postoperative outcomes. Methods PubMed, Web of Science and Cochrane Central Register were searched for RCTs comparing DHS and PFN for trochanteric fractures. All selected studies and the risk of bias were assessed. Clinical data including operative time, intraoperative blood loss, intraoperative fluoroscopy time, successful closed reduction and complications like nonunion, implant failure and reoperation were recorded. Random-effects models were used in Review Manager software, and GRADE was applied for the interpretation of the evidence. Results From 286 identified trials, twelve RCTs including 1889 patients were eligible for inclusion; six RCTs directly comparing DHS with PFN, while other six compared DHS with proximal femoral nail antirotation (PFNA). Compared to DHS, PFN had shorter operative time and led to less intraoperative blood loss. However, DHS need less intraoperative fluoroscopy time than PFN. No difference was seen for the achievement of closed reduction. For risk of postoperative complications, no difference was seen between PFN and DHS for non-union, risk of implant failure and revision surgery. Conclusions PFN(A) resulted in a shorter operative time and less intraoperative blood loss compared to DHS. However, no difference was seen for postoperative complications.
dc.identifier.doi10.1186/s13018-022-03189-z
dc.identifier.endpage-en_US
dc.identifier.issn1749-799X
dc.identifier.issue1en_US
dc.identifier.pmid35658909
dc.identifier.scopusqualityQ1
dc.identifier.startpage-en_US
dc.identifier.urihttps:/dx.doi.org/10.1186/s13018-022-03189-z
dc.identifier.urihttps://hdl.handle.net/20.500.12451/9486
dc.identifier.volume17en_US
dc.identifier.wosWOS:000805819700005
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBMC
dc.relation.ispartofJournal of Orthopaedic Surgery and Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTrochanteric Fractures
dc.subjectDynamic Hip Screw,
dc.subjectProximal Femur Screw
dc.subjectMeta-Analysis
dc.subjectImplant Failure
dc.subjectRevision Surgery
dc.titleComparative effectiveness research on proximal femoral nail versus dynamic hip screw in patients with trochanteric fractures: a systematic review and meta-analysis of randomized trials
dc.typeReview Article

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