Clinical Research Papers:
Network metaanalysis of surgical treatment for unstable femoral intertrochanteric fractures
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He-Hui Wang1, Wu-Bin Shu1, Guan-Hua Lan1, Xiao-Bo Zhang1, Zhi-Qiang Jiang1, De-Hong Xu1, Xue-Xun Bao1 and A-Bing Li1
1Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo, Zhejiang, 315100, China
Correspondence to:
A-Bing Li, email: [email protected]
Keywords: unstable femoral intertrochanteric fractures; proximal femoral nail antirotation; gamma nail; sliding hip screws; network meta-analysis
Received: October 12, 2017 Accepted: December 05, 2017 Epub: January 02, 2018 Published: May 08, 2018
ABSTRACT
In this network meta-analysis, we determined the optimal surgical method for treating unstable femoral intertrochanteric fractures. We searched the EMBASE, Cochrane Library and Medline databases for studies evaluating sliding hip screws (SHS), gamma nail (GN) or proximal femoral nail antirotation (PFNA) methods, and included nine randomized controlled trials that met the inclusion criteria. Our analysis showed no differences in the rates of complications between SHS and PFNA relative to GN (p > 0.05). However, the surface under the cumulative ranking curve (SUCRA) score for PFNA (77.6%) was higher than the SUCRA scores for GN (65%) and SHS (7.5%). This suggests PFNA is the better surgical method than GN or SHS for unstable femoral intertrochanteric fractures.