College of Mathematics, Jilin University, Changchun, Jilin Province, People's Republic of China.
Department of Hand Surgery, The Second Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.
J Orthop Surg Res. 2022 Mar 2;17(1):127. doi: 10.1186/s13018-022-02914-y.
Femoral neck fractures have a higher incidence in older people with poor prognosis, inducing serious social problems. Common treatment methods include total hip arthroplasty, bipolar hemiarthroplasty, double-screw fixation, multiple-screw fixation, and dynamic hip system.
We searched through four electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase databases, for articles regarding femoral neck fractures, bone screw, and hip prosthesis published up to February 11, 2020. All included articles were used for quality evaluation and data extraction. Extracted data were expressed as odds ratios or weighted mean differences, with 95% confidence intervals. We conducted a network meta-analysis for Harris hip score, complications, 1-year mortality rate, reoperation rate, intraoperative blood loss, and duration of operation using STATA version 16.0 software.
Twenty-two randomized controlled trials and nine cohort studies included in this study involved 3861 patients. Total hip arthroplasty significantly improved the postoperative function of patients with femoral neck fractures. The surface under the cumulative ranking curve value of the Harris hip score for more than 1 year after total hip arthroplasty was 98.2.
This meta-analysis indicated no significant difference in mortality among different treatment groups. Total hip arthroplasty can provide satisfactory outcomes in hip joint function, and double-screw fixation results in the lowest intraoperative risk. In general, total hip arthroplasty results in a lower incidence of adverse events and is especially recommended for patients with femoral neck fractures. This article has been retrospectively registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) on November 27, 2020. Registration number: INPLASY2020110123.
股骨颈骨折在预后较差的老年人中发病率较高，引发严重的社会问题。常见的治疗方法包括全髋关节置换术、双极半髋关节置换术、双螺钉固定、多螺钉固定和动力髋系统。
我们检索了四个电子数据库，包括 PubMed、Web of Science、Cochrane Library 和 Embase 数据库，检索截至 2020 年 2 月 11 日发表的关于股骨颈骨折、骨螺钉和髋关节假体的文章。所有纳入的文章均用于质量评估和数据提取。提取的数据表示为比值比或加权均数差，置信区间为 95%。我们使用 STATA 版本 16.0 软件对 Harris 髋关节评分、并发症、1 年死亡率、再次手术率、术中出血量和手术持续时间进行网络荟萃分析。
本研究纳入了 22 项随机对照试验和 9 项队列研究，共 3861 例患者。全髋关节置换术显著改善了股骨颈骨折患者的术后功能。全髋关节置换术后 1 年以上的 Harris 髋关节评分累积排序曲线下面积值为 98.2。
这项荟萃分析表明，不同治疗组之间的死亡率无显著差异。全髋关节置换术可提供满意的髋关节功能结果，双螺钉固定术中风险最低。总的来说，全髋关节置换术不良事件发生率较低，特别推荐用于股骨颈骨折患者。本研究已于 2020 年 11 月 27 日在国际注册系统评价与荟萃分析方案平台（INPLASY）上进行了回顾性注册。注册号：INPLASY2020110123。
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