Comparing different treatments for femoral neck fracture of displacement type in the elderly:a meta analysis / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the effects and security between internal fixation and total hip arthroplasty for the patients in elderly with femoral neck fracture of displacement type through a meta analysis.</p><p><b>METHODS</b>Studies on comparison between internal fixation and total hip arthroplasty for the patients in the elderly with femoral neck fracture of displacement type were identified from PubMed database,EMBase database, COCHRANE library, CMB database, CNKI database and MEDLINE database. Data analysis were performed using Revman 5.2.6(the Cochrane Collaboration).</p><p><b>RESULTS</b>Six published randomized controlled trials including 627 patients were suitable for the review, 286 cases in internal fixation group and 341 cases in total hip arthroplasty group. The results of meta analysis indicated that statistically significant difference were observed between the two groups in the quality of life which was reflected by the Harris scale (RR = 0.82, 95%CI0.72-0.93, P < 0.05) , the reoperation rate (RR = 5.81, 95%CI3.09-10.95, P < 0.05) and the major complications rate (RR = 3.60, 95%CI2.29-5.67, P < 0.05) postoperatively. There were no difference in the mortality at 1 year and 5 years postoperatively(P > 0.05).</p><p><b>CONCLUSIONS</b>For the patients with femoral neck fracture of displacement type in the elderly, there is no statistical difference between two groups in the mortality postoperatively. The quality of life and the security of operation in internal fixation group is worse than the total hip arthroplasty group.</p>