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Internal fixation implants for intracapsular proximal femoral fractures in adultsParker MJ, Stockton G, Gurusamy KS
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SummaryNo major difference found between different implants used to fix certain types of hip fracturesMany different types of implants are used to fix fractures of the hip, which are close to the hip joint (intracapsular fractures). Implants are used to stabilise the bone during healing thereby reducing the chance of the bones slipping out of line. They consist of either screws or pins and may have an additional side plate attached, which is fixed to the bone. This review found no evidence from trials undertaken so far that there were any major differences in outcomes from using particular implants.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 23. 2001 AbstractBackgroundNumerous different implants with screws, pins and side plates have been used for the internal fixation of intracapsular hip fractures. ObjectivesTo determine from randomised trials which implant is superior for the internal fixation of intracapsular proximal femoral fractures. Search strategyWe searched the Cochrane Bone, Joint and Muscle Trauma Group specialised register which is compiled from multiple databases, including regular searches of the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE and CINAHL, and handsearch results. The date of the most recent search was March 2003. Further trials were identified by checking reference lists of articles, general perusal of conference proceedings and personal contact with trialists. Selection criteriaRandomised and quasi-randomised trials comparing different implants for the internal fixation of intracapsular hip fractures in adults. Data collection and analysisTwo reviewers independently assessed trial quality, by use of a ten item scale, and extracted data. Additional information was sought from trialists. After grouping by implant type, comparable groups of trials were subgrouped and where appropriate, data were pooled using the fixed effects model. Main resultsTwenty-eight studies involving 5547 participants (5552 fractures) were included in the study. Considerable variation in the quality of methodology between studies was found and biases due to familiarity with some of the implants were noted. None of the implants tested were found to be significantly superior for any of the outcome measures related to fracture healing complications or mortality. The sliding hip screw was found to take longer to insert and to have an increased operative blood loss compared with multiple screws or pins. Authors' conclusionsNo clear conclusions can be made on the choice of implant for internal fixation of intracapsular fractures from the available evidence within randomised trials. |