Prospective comparison of PFBN and PFNA in treating elderly unstable intertrochanteric fractures.

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Abstract

Conflict of interest statement: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study was reviewed and approved by the Ethics Committee of the Nanping First Hospital Affiliated to Fujian Medical University Nanping (Approval No.: NPSY202405013). Written informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. 14. Int J Surg. 2017 Jul;43:67-74. doi: 10.1016/j.ijsu.2017.05.042. Epub 2017 May 23. Intramedullary nails versus sliding hip screws for AO/OTA 31-A2 trochanteric fractures in adults: A meta-analysis. Zhu Q(1), Xu X(1), Yang X(1), Chen X(1), Wang L(1), Liu C(1), Lin P(2). Author information: (1)Department of Trauma and Orthopedics, China-Japan Friendship Hospital, Beijing, China. (2)Department of Trauma and Orthopedics, China-Japan Friendship Hospital, Beijing, China. Electronic address: zryylp@sina.com. OBJECTIVES: The optimum treatment with intramedullary nails (IMN) or sliding hip screws (SHS) for type 31-A2 trochanteric fractures remains controversial. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with SHS in AO/OTA 31-A2 trochanteric fractures. MATERIAL AND METHODS: Databases including PubMed, Cochrane, and Embase were searched to identify RCTs published before December 2016, which compared IMN with SHS for intraoperative and postoperative outcomes in AO/OTA 31-A2 trochanteric fractures. RESULTS: A total of 909 patients from six RCTs were subjected to the meta-analysis. The results showed that the IMN group was associated with less operative blood loss, leg shortening, wound infections, length of hospital stay, and days to mobilization with walking aids and also yielded a higher Parker score as compared to the SHS group. No significant difference was seen in the other parameters including operative details, fracture fixation complications, postoperative complications, and 1 year mortality. CONCLUSION: IMN fixation was found to be the superior treatment of choice for 31-A2 trochanteric fractures as compared with SHS fixation in our meta-analysis. The adverse effects appeared comparable between the two groups. However, due to the variations in the included studies, more large-sample, measures-unified, and high-quality RCTs are needed to validate these conclusions. Copyright © 2017. Published by Elsevier Ltd. DOI: 10.1016/j.ijsu.2017.05.042