Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 2630-2638, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-230910
ABSTRACT
<p><b>BACKGROUND</b>There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures. In this article, we performed a systematic review and meta-analysis to compare the short- and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).</p><p><b>METHODS</b>PubMed, Embase, and the Cochrane Library were searched systematically up to January 2016. All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.</p><p><b>RESULTS</b>In total, eight prospective randomized studies involving 2206 patients were included. The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio 0.56, 95% confidence interval [CI] = 0.38-0.80), re-operation (risk ratio 0.17, 95% CI = 0.13-0.22), revision rates (risk ratio 0.11, 95% CI 0.08-0.16), and better function compared with their IF counterparts, and they were less likely to suffer postoperative pain. No statistically significant differences for the rates of mortality, infection, and/or deep vein thrombosis between AR and IF were found.</p><p><b>CONCLUSIONS</b>Based on our analysis, we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly. However, IF may be appropriate for those who are very frail.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Cirurgia Geral
/
Resultado do Tratamento
/
Artroplastia de Quadril
/
Fraturas do Colo Femoral
/
Fixação Interna de Fraturas
/
Métodos
Tipo de estudo:
Ensaio Clínico Controlado
/
Revisões Sistemáticas Avaliadas
Limite:
Idoso
/
Aged80
/
Humanos
Idioma:
Inglês
Revista:
Chinese Medical Journal
Ano de publicação:
2016
Tipo de documento:
Artigo
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