Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
J Orthop Surg Res. 2020 Aug 26;15(1):352. doi: 10.1186/s13018-020-01842-z.
Dynamic hip screw (DHS) and cannulated screws (CS) are widely used for femoral neck fractures. However, there is no definite result as to which surgical method bring less complications. We performed this study to compare the complication (mortality, non-union, avascular necrosis (AVN), and revision) of DHS and CS for the treatment of femoral neck fractures patients.
We searched Pubmed, Ovid, Cochrane Central Register of Controlled Trials, and other relevant studies related the comparison of DHS versus CS for femoral neck fractures from inception to Jan 7, 2020. The quality of the included randomized controlled trials (RCTs) and retrospective studies were assessed using the Cochrane Collaboration tool and Newcastle-Ottawa (NOS), respectively. The meta-analysis was performed by the RevMan 5.2 software.
Nine RCTs and seven retrospective cohort studies were included for meta-analysis. CS was found to be superior to DHS with respect to AVN rate (OR 1.47; 95% CI 1.08-1.99; p = 0.01, I = 0%). There were no significant between-group differences with respect to mortality, non-union, and revision (p > 0.05).
DHS and CS have similar complication including mortality, revision rate, and non-union, but CS has superior to DHS on ANV. However, further studies are required to provide more robust evidence owing to some limitations.
动力髋螺钉（DHS）和空心螺钉（CS）广泛应用于股骨颈骨折的治疗。然而，哪种手术方法并发症更少尚无明确结论。我们进行这项研究是为了比较 DHS 和 CS 治疗股骨颈骨折患者的并发症（死亡率、不愈合、股骨头坏死（AVN）和翻修）。
我们检索了 Pubmed、Ovid、Cochrane 对照试验中心注册库和其他相关研究，以比较 DHS 与 CS 治疗股骨颈骨折的研究，检索时间从建库至 2020 年 1 月 7 日。使用 Cochrane 协作工具和纽卡斯尔-渥太华量表（NOS）评估纳入的随机对照试验（RCT）和回顾性队列研究的质量。使用 RevMan 5.2 软件进行荟萃分析。
纳入了 9 项 RCT 和 7 项回顾性队列研究进行荟萃分析。CS 在 AVN 发生率方面优于 DHS（OR 1.47；95%CI 1.08-1.99；p = 0.01，I = 0%）。两组在死亡率、不愈合和翻修方面无显著差异（p > 0.05）。
DHS 和 CS 的并发症相似，包括死亡率、翻修率和不愈合，但 CS 在 AVN 方面优于 DHS。然而，由于存在一些局限性，需要进一步的研究提供更有力的证据。
