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Interlocking intramedullary nail for proximal femur versus proximal femoral anti-rotation intramedullary nail or proximal femoral anti-rotation intramedullary nail of asian for intertrochanteric fractures in older adults: A meta-analysis / 中国组织工程研究
Chinese Journal of Tissue Engineering Research ; (53): 477-485, 2021.
Article in Chinese | WPRIM | ID: wpr-847199
ABSTRACT

OBJECTIVE:

The most commonly used intramedullary fixation systems for the treatment of elderly intertrochanteric fractures include the proximal femoral anti-rotation intramedullary nail (PFNA), the proximal femoral anti-rotation intramedullary nail of Asian (PFNA-II) and interlocking intramedullary nail for proximal femur (Inter-TAN), but the clinical effect of the three in the treatment of A2 and A3 type intertrochanteric fractures is still controversial. Meta-analysis was used to compare the clinical efficacy of Inter-TAN, PFNA, and PFNA-II in the treatment of unstable intertrochanteric fractures in the elderly.

METHODS:

A computer was used to search databases such as Cochrane, Embase, PubMed, Sinomed, CNKI, Wanfang, and VIP to collect and compare the literatures of Inter-TAN, PFNA, and PFNA-II in the treatment of elderly unstable intertrochanteric fractures. The search period was from the establishment of the database to December 2019. Two reviewers independently read the screening literature, extracted data and evaluated the quality. Meta-analysis was performed using RevMan5.3 software.

RESULTS:

(1) A total of eight studies were included, with 1 349 patients, including two randomized controlled studies and six cohort studies. The evidence level was ≥ III. (2) Meta-analysis showed that the operation time and intraoperative fluoroscopy time were longer, and intraoperative blood loss was more in the Inter-TAN group than those of the PFNA-II group [MD=-16.60, 95%CI (-23.22,-9.99), P 0.05). There was no significant difference in tip-apex distance, length of hospital stay, and Harris score of Inter-TAN group compared with PFNA group and PFNA-II group (P > 0.05). The incidence of postoperative screw cut-out in the Inter-TAN group was less than in the PFNA group and the PFNA-II group [OR=6.47, 95%CI(2.79, 15.00), P 0.05).

CONCLUSION:

For patients with osteoporosis and poor stability, Inter-TAN can provide better stability and reduce postoperative complications. For patients with poor general conditions and greater surgical risk, PFNA-II internal fixation can be selected.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Observational study / Systematic reviews Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Observational study / Systematic reviews Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2021 Type: Article