Clinical outcomes and safety of F-shaped hollow screw internal fixation for treatment of femoral neck frac-ture:a meta-analysis
Objective:To systematically review the clinical outcomes and safety of F-shaped hollow screw internal fixation in treatment of femoral neck fracture(FNF).Methods:All the randomized controlled trial(RCT)and non-RCT articles about the clinical outcomes and safety of F-shaped hollow screw internal fixation(F-shaped fixation group)versus three hollow screws parallel internal fixation(parallel fixa-tion group)for treatment of FNF included from January 1,2011 to May 1,2024 were retrieved from the China National Knowledge Infrastruc-ture,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Cochrane Library,Embase and Web of Sci-ence.The pertinent articles were screened,the information was extracted and the risk of bias of the included researches was assessed inde-pendently by two researchers,and then a Meta-analysis was conducted by using Stata16.0 software.Results:Eleven articles(846 patients)were included in the final analysis,including 7 non-RCT articles,and 4 RCT articles.Four hundred and twenty-five patients in F-shaped fix-ation group,and 421 ones in parallel fixation group.The results of Meta-analysis revealed that the hospital stay was shorter,the reduction satisfaction rate and the Harris score measured at the last follow-up were higher,the fracture healing was faster,the hip pain visual analogue scale(VAS)score measured at the last follow-up and the incidence rates of femur head necrosis(FHN),fracture nonunion,femoral neck shortening and failed internal fixation were lower in F-shaped fixation group compared to parallel fixation group(MD=-2.45,95%CI(-3.42,-1.47),P=0.000;OR=3.49,95%CI(1.88,6.48),P=0.000;MD=7.62,95%CI(3.52,11.71),P=0.000;MD=-0.72,95%CI(-0.93,-0.50),P=0.000;MD=-2.07,95%CI(-2.39,-1.74),P=0.000;OR=0.32,95%CI(0.17,0.61),P=0.001;OR=0.42,95%CI(0.23,0.78),P=0.006;OR=0.40,95%CI(0.23,0.69),P=0.001;OR=0.25,95%CI(0.13,0.51),P=0.000);while,the differences in operative time,intraoperative blood loss,and intraoperative X-ray exposure were not statistically signifi-cant between the 2 groups.A re-evaluation was further performed on the aforementioned outcome indicators by employing a fixed-effect model and a random-effect model,respectively,and the results showcased that no evident change was found in the result of each outcome in-dicator,suggesting the results of the Meta-analysis in this study were relatively stable and reliable.Moreover,the publication bias was ana-lyzed based on the Harris score measured at the last follow-up,and the result of Bgger's test showed that there was no publication bias in the included articles(P=0.114).Conclusion:Available evidences suggest that,compared to the traditional parallel internal fixation with three hollow screws,the F-shaped hollow screw internal fixation behaves better in clinical outcomes and safety in the treatment of FNF,with-out increasing the difficulty of surgical operation or causing additional trauma to the patients.
femoral neck fracturesfracture fixation,internalbone screwsmeta-analysis as topic
万方数据
维普
