Femoral Neck Fracture Fixation (Comparison of Dynamic Hip Screw and Cannulated Screw Fixation)

Min, Byung Woo; Kang, Chul Hyung; Jung, Myung Hyun

doi:10.4055/jkoa.1999.34.2.365

Cited by 2 publications

(1 citation statement)

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“…Here, we report the details of 21 key excluded studies (see Characteristics of excluded studies). We excluded eight studies because the mean age of participants was younger than the expected population for the type of fracture (FAITH-2 2020;Kumar 2015;Min 1999;Okcu 2015;Qiu 2016;Siavashi 2015;Yin 2016;Yu 2013). The decision to exclude younger participants was a change from our protocol (see Differences between protocol and review).…”

Section: Excluded Studiesmentioning

confidence: 99%

Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis

Lewis

Macey

Stokes

et al. 2022

Cochrane Database of Systematic Reviews

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BackgroundHip fractures are a major healthcare problem, presenting a major challenge and burden to patients and healthcare systems. The number of hip fractures globally is rising rapidly. The majority of intracapsular hip fractures are treated surgically. ObjectivesTo assess the relative effects (benefits and harms) of all surgical treatments used in the management of intracapsular hip fractures in older adults, using a network meta-analysis of randomised trials, and to generate a hierarchy of interventions according to their outcomes. Search methodsWe searched CENTRAL, MEDLINE, Embase, Web of Science, and five other databases in July 2020. We also searched clinical trials databases, conference proceedings, reference lists of retrieved articles and conducted backward-citation searches. Selection criteriaWe included randomised controlled trials (RCTs) and quasi-RCTs comparing different treatments for fragility intracapsular hip fractures in older adults. We included total hip arthoplasties (THAs), hemiarthroplasties (HAs), internal fixation, and non-operative treatments. We excluded studies of patients with specific pathologies other than osteoporosis or resulting from high energy trauma. Data collection and analysisTwo review authors independently assessed studies for inclusion. One review author completed data extraction which was checked by a second. We collected data for three outcomes at different time points: mortality and health-related quality of life (HRQoL) -both reported within 4 months, at 12 months, and after 24 months of surgery, and unplanned return to theatre (at end of study follow-up).We performed a network meta-analysis (NMA) with STATA software, using frequentist methods, and calculated the differences between treatments using risk ratios (RRs) and standardised mean differences (SMDs) and their corresponding 95% confidence intervals (CIs). We also performed direct comparisons using the same codes. Main resultsWe included 119 studies (102 RCTS, 17 quasi-RCTs) with 17,653 participants with 17669 intracapsular fractures in the review; 83% fractures were displaced. The mean participant age ranged from 60 to 87 years and 73% were women.

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