학술논문

Stabilisation of AO OTA 31-A unstable proximal femoral fractures: Does the choice of intramedullary nail affect the incidence of post-operative complications? A systematic literature review and meta-analysis.
Document Type
Journal Article
Source
Injury. Mar2022, Vol. 53 Issue 3, p827-840. 14p.
Subject
*INTRAMEDULLARY rods
*HIP fractures
*INTRAMEDULLARY fracture fixation
*SURGICAL complications
*TREATMENT effectiveness
*ORTHOPEDIC implants
*META-analysis
*SYSTEMATIC reviews
*DISEASE incidence
*BONE screws
*FRACTURE fixation
*PROXIMAL femoral fractures
Language
ISSN
0020-1383
Abstract
Objective: To determine if there was a difference in the risk of post-operative complications associated with the use of different intramedullary (IM) devices in the treatment of unstable AO OTA 31-A trochanteric fractures.Design: Systematic literature review and meta-analysis.Methods: A systematic literature review was carried out in January 2022 in the Embase, MEDLINE and Cochrane databases. Studies comparing INTERTAN™ to other intramedullary nails for the treatment of AO OTA 31-A trochanteric fractures were selected for inclusion. After data extraction, meta-analyses were carried out on postoperative outcomes, with specific focus placed on unstable fracture patterns.Results: Twenty-three studies were suitable for inclusion, of which seventeen reported on outcomes in unstable fractures. INTERTAN reduced the risk of revision/reoperation by 64% (RR 0.36, 95% CI 0.25 to 0.54, p <0.0001), implant failures by 62% (RR 0.38, 95% CI 0.25 to 0.57, p<0.0001) and hip and thigh pain by 50% (RR 0.50, 95% CI 0.35 to 0.71, p=0.0001) in unstable fractures. No differences were noted between IM nail designs for infection rates, healing time, non-union rates, femoral shortening, or Harris Hip Score.Conclusions: The INTERTAN IM nail may reduce incidence of implant-related complications, hip and thigh pain, and the need for revision/reoperation without compromising clinical and functional outcomes. [ABSTRACT FROM AUTHOR]