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01.12.2014 | Original Article | Ausgabe 8/2014

European Journal of Orthopaedic Surgery & Traumatology 8/2014

Is helical blade superior to screw design in terms of cut-out rate for elderly trochanteric fractures? A meta-analysis of randomized controlled trials

Zeitschrift:
European Journal of Orthopaedic Surgery & Traumatology > Ausgabe 8/2014
Autoren:
Xiao Huang, Frankie Leung, Ming Liu, Long Chen, Zhao Xu, Zhou Xiang
Wichtige Hinweise
Frankie Leung and Zhou Xiang have contributed equally to this study.

Abstract

Purpose

This meta-analysis was conducted to investigate whether helical blade implant system had advantages in terms of cut-out rate when compared to screw implant system for trochanteric fractures of elderly population.

Methods

The databases of MEDLINE, Cochrane Library and OVID were searched from inception to September 2013, and all randomized controlled trials comparing outcomes between helical blade system and screw system in treating trochanteric fractures were selected. Three researchers assessed the methodological quality and extracted data of the enrolled studies independently. Data were analysed using Review Manager 5.1 version.

Results

Six studies including 759 patients were involved. Results revealed that compared with screw group, blade group had similar outcomes of “centre–centre” position (95 % CI 0.89–1.06, P = 0.48) and tip-apex distance (95 % CI−0.08 to 1.31, P = 0.08). Cut-out and other complications were also comparable between the two groups (95 % CI 0.34–1.54, P = 0.41; 95 % CI 0.73–1.32, P = 0.90). Operation time and fluoroscopy time of blade group were significantly less than that of screw group (95 % CI −5.13 to −3.70, P < 0.00001; 95 % CI −32.50 to −27.07, P < 0.00001). Outcome of post-operative function was similar between two groups (95 % CI 0.94–1.15, P = 0.45).

Conclusions

Blade group required less operation time and fluoroscopy time than that of screw group treating trochanteric fractures in the elderly, but the differences observed could be biased due to grouping and other limitations. Outcomes of cut-out complication, other complications, position of implant and post-operative function were similar between two groups.

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