Factors affecting recovery of hip function after intramedullary fixation of femoral intertrochanteric fractures in the elderly:A Meta-Analysis
Objective To systematically evaluate the factors influencing the impairment of hip function recovery after intramedul-lary fixation of femoral intertrochanteric fractures in the elderly.Methods the Cochrane Library,EMbase,PubMed,Web of Science,CNKI,China Biomedical Database,Wanfang Database,and VIP Database were systematically searched for publicly published studies on factors influencing the recovery of hip function after intramedullary fixation of femoral intertrochanteric fractures in the elderly,with a search time frame of January 1,2017 to March 10,2023.Two researchers independently performed literature screening,data extraction according to inclusion and exclusion criteria,and quality evaluation before conducting Meta-analysis using Review Manager 5.4 software.Meta-analysis results showed that fracture type(OR=4.81,95％CI 1.64～14.11,P=0.004＜0.01),ultra-early weight bearing(OR=29.95,95％CI 16.05～55.88,P＜0.00001),age(OR=4.32,95％CI 1.48～12.54,P=0.007＜0.01),bone mineral density(OR=7.36,95％CI 1.91～28.34,P=0.004＜0.01),ASA classification(OR=3.40,95％CI 2.15～5.38,P＜0.00001),plasma protein(OR=6.80,95％CI 1.99～23.22,P=0.002＜0.01),rehabilitation instructor instruction(OR=4.59,95％CI 2.08～10.14,P=0.0002＜0.01),reset quality(OR=12.24,95％CI 3.84～38.98,P＜0.00001),postoperative complications(OR=4.15 OR=4.15,95％CI 1.79～9.63,P=0.0009＜0.00001),combined underlying disease(OR=12.28,95％CI 8.91～16.92,P＜0.00001),mode of anesthesia(general anesthesia)(OR=5.19,95％CI 3.15～8.54,P＜0.00001),mode of anesthesia(intralesional anesthesia)(OR=14.69,95％CI 8.23～26.23,P＜0.00001)were influential factors for recov-ery of hip function.The timing of surgery(OR=2.65,95％CI 0.16～43.16,P=0.49＞0.01)was not an influencing factor for postoperative hip function recovery.Conclusion Stable fractures,ultra-early weight bearing,age＜70 years,BMD＞-2.5 SD,low risk of ASA classification,plasma protein level＞30 g/L,guidance by a rehabilitation officer,good repositioning,low incidence of postoperative complications,few comorbid underlying diseases,and choice of general anesthesia or intralesional anesthesia were all contributing factors for recovery of hip function after intramedullary fixation of intertrochanteric femoral fractures in the elderly,and there is no evidence that the timing of surgery is an influential factor in the recovery of hip function.
elderlyintertrochanteric fracturefemoral intertrochanteric fractureintramedullary nail fixationrecovery of func-tionrisk factorssecondary analysis
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