scholarly journals Proximal Femoral Nail versus Dynamic Hip Screw Fixation for Trochanteric Fractures: A Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao Huang ◽  
Frankie Leung ◽  
Zhou Xiang ◽  
Pei-Yong Tan ◽  
Jing Yang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Controlled Trials ◽  
Trochanteric Fractures ◽  
Randomized Controlled ◽  
Femoral Nail ◽  
Hip Screw

Background. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate.Methods. All randomized controlled trials comparing proximal femoral nail and dynamic hip screw in the treatment of trochanteric fractures were included. Articles and conference data were extracted by two authors independently. Data was analyzed using RevMan 5.1 version. Eight trials involving 1348 fractures were retrieved.Results. Compared with DHS fixation, PFN fixation had similar operation time (95% CI: −15.28–2.40,P=0.15). Blood loss and transfusion during perioperative time were also comparable between the two fixations (95% CI: −301.39–28.11,P=0.10; 95% CI: −356.02–107.20,P=0.29, resp.). Outcomes of hospital stay (95% CI: −0.62–1.01,P=0.64), wound complication (95% CI: 0.66–1.67,P=0.82), mortality (95% CI: 0.83–1.30,P=0.72), and reoperation (95% CI: 0.61–1.54,P=0.90) were all similar between the two groups.Conclusion. PFN fixation shows the same effectiveness as DHS fixation in the parameters measured.

scholarly journals Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lei Zhang ◽  
Jie Shen ◽  
Shengpeng Yu ◽  
Qiang Huang ◽  
Zhao Xie
Keyword(s):  
Blood Loss ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Plate Versus ◽  
Controlled Trials ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hip Screw

Background. Percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for the treatment of intertrochanteric fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus dynamic hip screw (DHS) fixation for intertrochanteric fractures.Methods. All randomized controlled trials (RCT) that compared PCCP with DHS in treating adult patients with intertrochanteric fractures were included. Main outcomes were collected and analysed using the RevMan 5.1 version.Results. Five trials met the inclusion criteria. Compared with DHS, PCCP had similar operation time (95% CI: −26.01~4.05,P= 0.15), length of hospitalization (95% CI: −1.79~1.25,P= 0.73), mortality (95% CI: 0.37~1.02,P= 0.06), incidence of implant-related complications (95% CI: 0.29~1.82,P= 0.49), and reoperation rate (95% CI: 0.41~3.05,P= 0.83). But blood loss (95% CI: −173.84~−4.81,P= 0.04) and transfusion need (95% CI: −0.53~−0.07,P= 0.01) significantly favored the PCCP.Conclusions. The PCCP was associated with reduced blood loss and less transfusion need, but similar to DHS in other respects. Owing to the limitations of this systematic review, more high-quality RCTs are still needed to assess the clinical efficiency of PCCP.

scholarly journals Dynamic Hip Screw (DHS) versus Proximal Femoral Nail Anti-rotation (PFNA) Fixation for Unstable (Evans-Jensen II and III) Inter-trochanteric Fractures of Femur in Elderly

2019 ◽  
Vol 15 (3) ◽  
pp. 222-225
Author(s):  
Manoj Kandel ◽  
Robin Shrestha ◽  
Krishna Prasad Poudel ◽  
Shrawan Thapa ◽  
Sushil Thapa ◽  
...  
Keyword(s):  
Average Length ◽  
Trochanteric Fracture ◽  
Operation Time ◽  
Healing Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Fixation Group ◽  
Hip Screw

Background: Dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) are the two most commonly used fixation devices for inter-trochanteric fracture of femur. However, many clinical studies have shown lack of differences in the  clinical outcome consistently with between these two fixation techniques. The main objective of this study is to compare the results of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) fixation in elderly patients with unstable inter-trochanteric fractures of femur. Methods: We retrospectively reviewed patients who underwent operative management for inter- trochanteric fractures of femur in our hospital between February 2013 and September 2017. Elderly   patients (Age >60yrs) with unstable inter-trochanteric fracture of femur treated either with DHS fixation or with PFNA fixation were included and divided into two groups: DHS fixation group and PFNA fixation group. The comparative statistical analysis was done between two group using following   parameters: average length of the incision, operation time, blood loss, fracture healing time, and degree of postoperative functional recovery. Results: The mean follow-up period, in DHS fixation group was 16 month (range 12 to 24 months) and in PFNA fixation group was 14 months (range 12 to 18 months). The differences between two groups regarding average length of the incision, operation time, and blood loss were statistically significant (p<0.05) and better in PFNA group whereas the differences between two groups regarding fracture healing time and the degree of postoperative functional recovery were not statistically significant (p >0.05). Conclusions: PFNA fixation may be  better than DHS fixation for the treatment of unstable inter-trochanteric fractures of the femur in the elderly. However, the application and usage of DHS fixation could not be neglected and the choice of treatment depends upon the systemic condition and socioeconomic status of the patient, patient’s preferences, surgeon’s experience and availability of treatment facility.

A comparison study of proximal femoral nail and dynamic hip screw devices in unstable trochanteric fractures

2018 ◽  
Vol 35 (3) ◽  
pp. 413
Author(s):  
MohamedA Mostafa ◽  
HassanH Ahmed ◽  
HaniA.M Bassiooni ◽  
ElsayedM Mohamady
Keyword(s):  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Comparison Study ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Hip Screw

scholarly journals Randomized comparative study to evaluate the role of proximal femoral nail and dynamic hip screw in unstable trochanteric fractures

2016 ◽  
Vol 2 (3) ◽  
pp. 75
Author(s):  
Shivanand C Mayi ◽  
Sachin Shah ◽  
Sadashiv R Jidgekar ◽  
Arunkumar Kulkarni
Keyword(s):  
Comparative Study ◽  
Functional Outcome ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Stable Fixation ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw

<p class="abstract"><strong>Background:</strong> Treatment of unstable trochanteric fracture is much more challenging than stable fracture. These fractures require stable fixation to minimize the fracture and implant related complications. Need of this study is to assess the suitable implant for stable fixation of unstable trochanteric fracture with less intra and postoperative complications and good functional outcome.</p><p class="abstract"><strong>Methods:</strong> In this prospective randomized comparative study, 64 patients were distributed into two groups. Group A consisted of patients treated by proximal femoral nail (PFN) (n=32) and group B treated by dynamic hip screw (DHS) (n=32). All the patients were evaluated preoperatively and surgery was done according to the group they were allotted. Post-operative follow up was done at 6 weeks, 3, 6 and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Average age of the patients in this study was 51.26±10.24 year. In this study patients were followed up for an average of 10.87±2.61 month. The duration of surgery was shorter in PFN group. Weight bearing was earlier in PFN group than DHS group. Mean functional ability score was better in PFN group with significant gain in function earlier as compared to DHS group.</p><strong>Conclusions:</strong> PFN is a better implant for internal fixation of unstable trochanteric fractures which allows early mobilization and has got better functional outcome score in early postoperative period than DHS

scholarly journals Treatment of Trochanteric Fractures with Proximal Femoral Nail Antirotation or Dynamic Hip Screw Systems: A Meta-Analysis

2012 ◽  
Vol 40 (3) ◽  
pp. 839-851 ◽  
Author(s):  
C Zeng ◽  
Y-R Wang ◽  
J Wei ◽  
S-G Gao ◽  
F-J Zhang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Meta Analysis ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intraoperative Blood Loss ◽  
Trochanteric Fractures ◽  
Fixation Failure ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation

OBJECTIVE: A meta-analysis to compare the intraoperative and postoperative outcome data for the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) implant systems for the treatment of patients with trochanteric fractures. METHODS: A detailed search of several electronic databases was undertaken to identify randomized controlled trials published before 5 December 2011 that compared PFNA with DHS in patients with trochanteric fractures. RESULTS: A quantitative meta-analysis of 11 studies including 798 patients was performed. PFNA was associated with significant reductions in duration of surgery (weighted mean difference [WMD] −21.38 min; 95% confidence interval [CI] −33.50, −9.26 min), intraoperative blood loss (WMD −176.36 ml; 95% CI −232.20, −120.52 ml), rate of fixation failure (relative risk [RR] 0.27, 95% CI 0.11, 0.62) and rate of postoperative complications (RR 0.46; 95% CI 0.31, 0.70) compared with DHS. CONCLUSION: The use of PFNA for treatment of trochanteric fractures was found to be superior to DHS in terms of the duration of surgery, intraoperative blood loss, and rates of fixation failure and overall complications.

A Meta-Analysis of Dynamic Hip Screw and Proximal Femoral Nail for Treatment of Intertrochanteric Fractures

2015 ◽  
Vol 2 ◽  
pp. 73-80
Author(s):  
Yong-tao Zhang ◽  
Jing Niu ◽  
Xin-zhi Chen ◽  
Zai-jie Tian ◽  
Guo-yong Qiao ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Hip Screw
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