Mariscal Gonzalo, Lorente Rafael, Barrios Carlos
Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain.
Department of Orthopedic Surgery, University Hospital of Badajoz, Badajoz, Spain.
Front Surg. 2022 Nov 23;9:1015554. doi: 10.3389/fsurg.2022.1015554. eCollection 2022.
Intertrochanteric fracture is a growing problem in the traumatology department. The use of intramedullary devices has increased, representing the first treatment option in intertrochanteric fractures. U-Blade devices appeared to avoid rotation of the femoral head over the femoral neck. The aim of this study was to conduct a meta-analysis of the surgical treatment of intertrochanteric fractures comparing in terms of safety and efficacy the U-Blade Gamma 3 nail vs. the conventional Gamma 3 nail.
A literature search for intertrochanteric fracture 31A1-31A3 according to the AO foundation/orthopaedic trauma association (AO/OTA) classification was performed. Baseline characteristics of each article were obtained; radiological outcomes were tip apex distance (TAD), sliding distance (mm), cut-out rate, and lateralization rate. Surgery time (min) was also recorded. A meta-analysis was performed with ReviewManager 5.4.
Five retrospective studies ( = 993 patients) were included. With respect to TAD and sliding distance, there were no differences between two groups [mean difference (MD) 0.47, 95% confidence interval (CI), -0.46 to 1.40] and (MD 0.39, 95% CI, 0.13-0.66). The cut-out rate and lateralization rate did not show differences between two groups ( > 0.05). Finally, surgery time was significantly higher in the U-Blade Gamma 3 group (MD -4.84, 95% CI, -7.22 to -2.46).
The use of U-Blade Gamma 3 did not show significant differences in the radiological results compared with the conventional Gamma 3 nail.
转子间骨折是创伤科日益突出的问题。髓内固定装置的使用有所增加，成为转子间骨折的首选治疗方法。U型刀片装置似乎可避免股骨头在股骨颈上旋转。本研究的目的是对转子间骨折的手术治疗进行荟萃分析，比较U型刀片Gamma 3钉与传统Gamma 3钉在安全性和有效性方面的差异。
根据AO基础/骨科创伤协会（AO/OTA）分类对31A1-31A3型转子间骨折进行文献检索。获取每篇文章的基线特征；放射学结果包括尖顶距（TAD）、滑动距离（mm）、穿出率和侧方化率。还记录了手术时间（分钟）。使用ReviewManager 5.4进行荟萃分析。
纳入五项回顾性研究（n = 993例患者）。在TAD和滑动距离方面，两组之间无差异[平均差（MD）0.47，95%置信区间（CI），-0.46至1.40]和（MD 0.39，95%CI，0.13 - 0.66）。两组的穿出率和侧方化率无差异（P>0.05）。最后，U型刀片Gamma 3组的手术时间明显更长（MD -4.84，95%CI，-7.22至-2.46）。
与传统Gamma 3钉相比，使用U型刀片Gamma 3钉在放射学结果上未显示出显著差异。
