Long Sulan, Nuntaboot Khanitta, Nakrukamphonphatn Suvapat, Zhu Wangqiao, Liu Jia, Zhang Meiyan, Yu Daofang
Faculty of Nursing, Khon Kaen University, Khon Kaen, 40002, Khon Kaen Province, Thailand.
Faculty of Nursing, Nanchang Medical College, Nanchang, 330052, Jiangxi Province, China.
Eur J Med Res. 2025 May 29;30(1):427. doi: 10.1186/s40001-025-02684-3.
Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) is widely used for the treatment of femoral neck fractures.
This study conducted a comparative and meta-analysis of the therapeutic effects of different screw fixation methods in femoral neck fractures, with the aim of finding a better treatment.
Pubmed, Embase, Cochrane Library and Web of science databases were searched using MeSH Terms combined with free words without time or language constraints. MeSH Terms were "femoral neck fractures", "Sliding Hip Screw", "Cancellous Screws", "Fixation using Alternative Implants for the Treatment of Hip fractures", "over 50 years old". The search deadline is August 15, 2024. Two researchers sifted through the retrieved literature to come up with the included literature. After a close reading of the literature, Review Manager 5.4 was used to analyze the risk of bias in the included literature, compare various indicators of different screw fixation, and make forest and funnel maps.
214 literatures were retrieved from 4 databases were included in the study after screening. The bias of the included literature is good, and the randomness and blindness are clearly indicated in this paper. Pauwels Type III (Chi = 0.00, df = 3, I = 0%, z = 0.80, p = 0.43), fall (Chi = 2.23, df = 2, I = 10%, z = 1.88, p = 0.06) and Mortality (Chi = 4.80, df = 2, I = 58%, z = 3.53, p = 0.0004) were lower in sliding hip screws than in cancellous screws. Garden type III and IV (Chi = 1.37, df = 3, I = 0%, z = 0.71, p = 0.48) and Infection (Chi = 0.01, df = 2, I = 0%, z = 0.28, p = 0.78) were lower in sliding hip screws than in cancellous screws (Both p > 0.05).
In Femoral neck fractures, sliding hip screws have a distinct advantage over cancellous screws. This has guiding significance for clinical treatment. Elderly patients with femoral neck fractures should be given priority for fixation with sliding hip screws.
使用替代植入物治疗髋部骨折（FAITH）广泛应用于股骨颈骨折的治疗。
本研究对不同螺钉固定方法治疗股骨颈骨折的疗效进行比较和荟萃分析，旨在找到更好的治疗方法。
使用医学主题词（MeSH）结合自由词检索PubMed、Embase、Cochrane图书馆和Web of science数据库，无时间或语言限制。MeSH词为“股骨颈骨折”“滑动髋螺钉”“松质骨螺钉”“使用替代植入物治疗髋部骨折”“50岁以上”。检索截止日期为2024年8月15日。两名研究人员筛选检索到的文献以得出纳入文献。仔细阅读文献后，使用Review Manager 5.4分析纳入文献的偏倚风险，比较不同螺钉固定的各项指标，并制作森林图和漏斗图。
经筛选，从4个数据库检索到的214篇文献纳入本研究。纳入文献的偏倚良好，本文明确指出了随机性和盲法。滑动髋螺钉治疗Pauwels III型骨折（卡方=0.00，自由度=3，I²=0%，z=0.80，p=0.43）、跌倒（卡方=2.23，自由度=2，I²=10%，z=1.88，p=0.06）和死亡率（卡方=4.80，自由度=2，I²=58%，z=3.53，p=0.0004）低于松质骨螺钉。滑动髋螺钉治疗Garden III型和IV型骨折（卡方=1.37，自由度=3，I²=0%，z=0.
