Department of Orthopaedic Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
Department of Orthopaedic Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Orthop Traumatol Surg Res. 2021 Oct;107(6):103005. doi: 10.1016/j.otsr.2021.103005. Epub 2021 Jul 1.
Since its introduction in the early 1960s, the multiple cannulated screw fixation method has been developed for use in femoral neck fractures (FNFs); however, the parallelism of screws remains controversial.
MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published before June 2, 2020, that compared the use of parallel and non-parallel screw fixation for the treatment of FNF. The pooled analysis was designed to identify differences between the two groups and focused on postoperative complications, including fracture nonunion and osteonecrosis of the femoral head (ONFH).
Over four studies, we enrolled 445 patients, including 195 patients with fixed FNF with parallel trajectory screws and 250 patients with fixed FNF with non-parallel screws. The pooled analysis showed no difference in the nonunion rates (odds ratio (OR)=0.91; 95% confidence interval (CI), 0.24-3.44; p=0.89) and no significant difference in the incidence of ONFH between parallel and non-parallel screw fixation (OR=0.74; 95% CI: 0.21-2.63; p=0.64).
The results of this meta-analysis reveal that screw parallelism in multiple cannulated screw fixation of FNF has no relationship with either the fracture nonunion rate or the incidence of postoperative ONFH.
III; meta-analysis.
自 20 世纪 60 年代初引入以来，多枚空心钉固定法已应用于股骨颈骨折（FNF）；然而，螺钉的平行度仍存在争议。
系统检索了 MEDLINE、Embase 和 Cochrane 图书馆中截至 2020 年 6 月 2 日前发表的比较平行和非平行螺钉固定治疗 FNF 的研究。汇总分析旨在确定两组之间的差异，并集中于术后并发症，包括骨折不愈合和股骨头坏死（ONFH）。
在四项研究中，我们纳入了 445 名患者，其中 195 名患者采用平行轨迹螺钉固定 FNF，250 名患者采用非平行螺钉固定 FNF。汇总分析显示，两组的不愈合率（比值比（OR）=0.91；95%置信区间（CI），0.24-3.44；p=0.89）和术后 ONFH 的发生率（OR=0.74；95%CI：0.21-2.63；p=0.64）均无差异。
本荟萃分析结果表明，FNF 多枚空心钉固定中螺钉的平行度与骨折不愈合率或术后 ONFH 的发生率无关。
III；荟萃分析。
