Introduction: Intertrochanteric fractures are predominantly treated by dynamic hip screw (DHS) fixation. However, recent evidence has found acceptable clinical results following hemiarthroplasty for these fractures. Thus, a systematic review was conducted to compare hemiarthroplasty with DHS fixation for intertrochanteric fractures.
Methods: A computerised search was performed, using the databases Medline, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials, with supplementation from Google Scholar and appropriate reference lists. Studies with comparative data comparing clinical outcomes of hemiarthroplasty versus DHS fixation were included. Data were extracted and quality assessment of the papers performed by 2 reviewers.
Results: 320 articles were independently reviewed by the investigators. A total of 10 studies met the inclusion criteria, comprising 2 randomised controlled trials and 8 cohort designs. 7 of the studies assessed unstable fracture patterns. There was no difference in operating time (SMD -1.169 min; 95% CI, -0.657 to 0.689) or blood transfusion volume (SMD-0.110 units; 95% CI, -0.520 to 0.891) between modalities. There was also no difference in length of stay (SMD -0.778 days; 95% CI, -0.606 to 0.336), mortality (RR 0.942; 95% CI, 0.749-1.183) or major complications. Hemiarthroplasty conferred significantly better Harris Hip Scores at 12 months (SMD 12.3; 95% CI, 0.0135-2.789) and allowed earlier weight-bearing than DHS fixation.
Discussion: Qualitative and quantitative compilation of the included studies demonstrates hemiarthroplasty to result in better functional scores and a quicker time to weight-bearing than DHS fixation for intertrochanteric fractures. Results are comparable for other major parameters, including operative time, length of stay and mortality. Thus, hemiarthroplasty is a suitable alternative to DHS fixation for unstable intertrochanteric fractures in elderly patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/11207000221112579 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Incidence of Popeye Deformity After Soft-Tissue Biceps Tenodesis Is Comparable to Biceps Anchor Tenodesis and Lower Than Biceps Tenotomy During Arthroscopic Rotator Cuff Repair.
Arthroscopy
November 2024
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:
Purpose: To compare clinical and radiologic outcomes between biceps anchor tenodesis (AT), biceps soft-tissue tenodesis (ST), and biceps tenotomy (TT) for patients with concomitant rotator cuff repair (RCR).
Methods: This retrospective study reviewed patients who underwent arthroscopic RCR for full-thickness rotator cuff tears with AT, ST, or TT with minimum 2-year follow-up. All biceps procedures were performed arthroscopically, and ST consisted of fixation to the transverse humeral ligament.
Association between hip fracture fixation methods and bone mineral density T-value in middle-aged and elderly patients with hip fractures.
Am J Transl Res
October 2024
Laboratory, The First Affiliated Hospital of Jinzhou Medical University Jinzhou 121000, Liaoning, China.
Objective: To examine the association of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) with bone mineral density T-value (BMDT) in middle-aged and elderly patients suffering from hip fractures.
Methods: Clinical data were collected from 110 patients with hip fractures who underwent internal fixation surgery between October 2020 and June 2021. Patients treated with DHS were included in the control group, and those treated with PFNA were classified into the observation group.
Intertrochanteric Fracture Fixation Using a Traction Table in a Patient with Ipsilateral Above-knee Amputation - A Case Report and Review of Reduction Techniques.
J Orthop Case Rep
November 2024
Department of Trauma and Orthopaedics, Salford Royal Hospital, Salford, Greater Manchester M6 8HD.
Introduction: Although commonly encountered in clinical practice and considered among the "bread and butter" cases in trauma and orthopedics, intertrochanteric fractures of the femur in certain scenarios pose a challenge to the orthopedic surgeon. Good reduction and stable fixation are a key for good outcome, and certain anatomical limitations such as amputations make that difficult to achieve. Ipsilateral above-knee amputation is a scenario where positioning of the patient on an orthopedic fracture table and reduction of the fracture becomes challenging.
View Article and Find Full Text PDFManagement of Failed Fixation of Extracapsular Hip Fractures.
Cureus
November 2024
Trauma and Orthopaedics, Gloucestershire Royal Hospital, Gloucester, GBR.
Background Extracapsular hip fractures are routinely treated with fixation, and the majority heal without complication. The fixation fails in a minority of cases, typically either by 'cutting out' of the superior femoral head or through breakage of the metalwork following non-union. In such cases, if operative treatment is thought appropriate, there are two major treatment options: revision fixation of the fracture or joint replacement surgery.
View Article and Find Full Text PDFTechnical Note in Case Series a Novel Recent Technique for the Removal of Broken PFNA-II Blade in Intertrochanteric Fractures is a Technical Challenge.
J Orthop Case Rep
November 2024
Department of Orthopaedics, Jaipur Golden Hospital, Institutional Area Sector 3 Rohini, Delhi, India.
Introduction: Proximal femoral nail antirotation - II (PFNA- II) is a common treatment for intertrochanteric fractures in the elderly. Removing PFNA is difficult in rare circumstances due to blade head stripping or breaking. In this article, we endeavored to explain an easy methodology that can be utilized to remove stripped, damaged anti-rotation blades for which few had been formulated but other procedures have failed.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!