Hemiarthroplasty compared with internal fixation for treatment of nondisplaced femoral neck fractures in elderly patients: a retrospective study

Chen, Jun-Yuan; She, Guorong; Luo, Simin; Wu, Wenrui; Zhuang, Tengfeng; Huan, Shi; Liu, Ning; Zha, Zhengang

doi:10.1016/j.injury.2020.02.098

Cited by 16 publications

(21 citation statements)

References 20 publications

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“…Elderly patients treated with hemiarthroplasty had a lower reoperation rate was reported in three studies 13,14,16 . Chen et al . 18,19 pointed out there was no significant difference in mortality rate in the midterm follow‐up, while Sikand et al .…”

Section: Resultsmentioning

confidence: 91%

“…There were 412 cases in the screw fixation group and 338 cases in the hemiarthroplasty group. Three studies 13–15 found hemiarthroplasty was associated with less postoperative complications. Elderly patients treated with hemiarthroplasty had a lower reoperation rate was reported in three studies 13,14,16 .…”

Section: Resultsmentioning

confidence: 99%

“…20 found a significant increase in mortality when treating with hemiarthroplasty. Two studies 13,19 reported better hip function recovery in elderly patients who received hemiarthroplasty, but another two 14,16 suggested there was no significant difference in functional recovery.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies 13–16,19,20 involving 750 patients reported reoperation rate after screw fixation and hemiarthroplasty. A significant difference was found between the two groups ( OR , 4.88 [95% CI , 2.84 to 8.38]; P < 0.00001; I 2 = 0).…”

Section: Resultsmentioning

confidence: 99%

“…To identify a better treatment, some researchers directly compared the efficacy between screw fixation and hemiarthroplasty in such patients, but no consensus was reached. Some studies indicated that elderly patients treated with hemiarthroplasty could achieve fewer complications, lower reoperation rate, and better hip function in the early stage 13, 14 . But others reported no significant differences in reoperation rate and hip function between those two treatments 15, 16 .…”

Section: Introductionmentioning

confidence: 99%

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Long‐Term Efficacy of Screw Fixation vs Hemiarthroplasty for Undisplaced Femoral Neck Fracture in Patients over 65 Years of Age: A Systematic Review and Meta‐Analysis

Xue

2021

Orthopaedic Surgery

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Objective To compare the long‐term efficacy of screw fixation and hemiarthroplasty in elderly patients with undisplaced femoral neck fractures. Methods We searched Cochrane Library, EMBASE, and MEDLINE from inception to 10 June 2020 to identify studies about undisplaced femoral neck fracture in elderly patients over 65 years of age. The included studies were assessed by two researchers according to the Cochrane risk‐of‐bias criteria and Newcastle–Ottawa Scale. Meta‐analysis was performed with Revman 5.3 software. The odds ratios (OR) and mean differences (MD) were used to compare dichotomous and continuous variables. Results A total of 750 patients were included in this meta‐analysis. In elderly patients, undisplaced femoral neck fracture treated with hemiarthroplasty had a lower implant‐related complication rate (OR, 4.05 [95% CI, 2.38 to 6.89]; P < 0.00001; I2 = 0), lower reoperation rate (OR, 4.88 [95% CI, 2.84 to 8.38]; P < 0.00001; I2 = 0), and superior Harris score (WMD, −5.05 [95% CI, −7.30 to −2.80]; P < 0.0001; I2 = 0) in the early postoperative period. Although screw fixation was associated with shorter operative time (WMD, −36.22 [95% CI, −50.72 to −21.73]; P < 0.00001; I2 = 98%) and less blood loss (WMD, −165.84 [95% CI, −209.29 to −122.38]; P < 0.00001; I2 = 96%), there was no significant difference in long‐term mortality (OR, 0.65 [95% CI, 0.28 to 1.48]; P < 0.31; I2 = 75%) between these two treatments. Conclusion In elderly patients with undisplaced femoral neck fractures, hemiarthroplasty provided a lower implant‐related complication rate, lower reoperation rate, superior hip function without increased long‐term mortality. Hemiarthroplasty should be recommended as a better alternative in such patients compared with multiple cannulated screws.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%