Zeng C, Wang Y-R, Wei J, Gao S-G, Zhang F-J, Sun Z-Q, Lei G-H
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
J Int Med Res. 2012;40(3):839-51. doi: 10.1177/147323001204000302.
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.
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.
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.
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.
进行一项荟萃分析，比较股骨近端防旋髓内钉（PFNA）和动力髋螺钉（DHS）植入系统治疗转子间骨折患者的术中和术后结果数据。
对多个电子数据库进行详细检索，以识别2011年12月5日前发表的比较PFNA与DHS治疗转子间骨折患者的随机对照试验。
对11项研究（共798例患者）进行了定量荟萃分析。与DHS相比，PFNA在手术时间（加权平均差[WMD] -21.38分钟；95%置信区间[CI] -33.50，-9.26分钟）、术中失血量（WMD -176.36毫升；95% CI -232.20，-120.52毫升）、固定失败率（相对危险度[RR] 0.27，95% CI 0.11，0.62）和术后并发症发生率（RR 0.46；95% CI 0.31，0.70）方面均有显著降低。
在手术时间、术中失血量、固定失败率和总体并发症方面，发现使用PFNA治疗转子间骨折优于DHS。
