Is helical blade superior to screw design in terms of cut-out rate for elderly trochanteric fractures? A meta-analysis of randomized controlled trials

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• 作者：Xiao Huang (1)
  Frankie Leung (2)
  Ming Liu (1)
  Long Chen (1)
  Zhao Xu (1)
  Zhou Xiang (1)
  
• 关键词：Blade ; Screw ; Trochanteric fracture ; Cut ; out ; Meta ; analysis
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：24
• 期：8
• 页码：1461-1468
• 全文大小：1,114 KB
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• 作者单位：Xiao Huang (1)
  Frankie Leung (2)
  Ming Liu (1)
  Long Chen (1)
  Zhao Xu (1)
  Zhou Xiang (1)
  
  1. Department of Orthopaedics, West China Hospital, Sichuan University, 37# Guoxue Rd, Chengdu, 610041, Sichuan, China
  2. Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
  
• ISSN：1432-1068

文摘

Purpose This meta-analysis was conducted to investigate whether helical blade implant system had advantages in terms of cut-out rate when compared to screw implant system for trochanteric fractures of elderly population. Methods The databases of MEDLINE, Cochrane Library and OVID were searched from inception to September 2013, and all randomized controlled trials comparing outcomes between helical blade system and screw system in treating trochanteric fractures were selected. Three researchers assessed the methodological quality and extracted data of the enrolled studies independently. Data were analysed using Review Manager 5.1 version. Results Six studies including 759 patients were involved. Results revealed that compared with screw group, blade group had similar outcomes of “centre–centre-position (95?% CI 0.89-.06, P?=?0.48) and tip-apex distance (95?% CI?.08 to 1.31, P?=?0.08). Cut-out and other complications were also comparable between the two groups (95?% CI 0.34-.54, P?=?0.41; 95?% CI 0.73-.32, P?=?0.90). Operation time and fluoroscopy time of blade group were significantly less than that of screw group (95?% CI ?.13 to ?.70, P?P?P?=?0.45). Conclusions Blade group required less operation time and fluoroscopy time than that of screw group treating trochanteric fractures in the elderly, but the differences observed could be biased due to grouping and other limitations. Outcomes of cut-out complication, other complications, position of implant and post-operative function were similar between two groups.