Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Zhang, Lei; Shen, Jie; Yu, Shengpeng; Huang, Qiang; Xie, Zhiyong

doi:10.1155/2014/512512

Cited by 10 publications

(8 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of this study were consistent to previous meta-analyses [8,15,19,22,29,30]; five studies were to compare proximal femoral nail (with or without anti-rotation). Three studies suggest that PFN can reduce blood loss, operative time, blood transfusion and fewer complications in the treatment of intertrochanteric fractures when compared with DHS, whereas two studies show the same effectiveness as DHS.…”

Section: Discussionsupporting

confidence: 89%

“…PFNA provides angular and rotational stability, which is especially important in osteoporotic bone, and allows early mobilization and weight bearing on the affected limb [13,17]. From literature review, we found 8 systematic reviews were published and dealing with the type of fixation of intertrochanteric fracture [7,8,15,19,22,[28][29][30]. However, none of the reviews compared all the implants, and none incorporated their comparative effectiveness using a network meta-analysis approach.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials

Arirachakaran

Amphansap

Thanindratarn

et al. 2017

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. The aim of this systematic review is to conduct a network meta-analysis of randomized controlled trials (RCTs) comparing clinical outcomes between dynamic hip screws (DHS), Medoff sliding plating, percutaneous compression plating (PCCP), proximal femoral nails (PFN), Gamma nails and less invasive stabilization system fixation in femoral trochanteric fractures in the elderly. These clinical outcomes consist of total intra-operative time, intra-operative fluoroscopy time, intra-operative blood loss, blood component transfusion, length of hospital stay, postoperative general complications, wound complications, late complications and reoperation rates. This systematic review was conducted using PubMed and Scopus search engines for RCTs comparing clinical outcomes between treatments from inception to February 22, 2015. Thirty-six of 785 studies identified were eligible. Compared to the other implants, PCCP showed the lowest total operative time and units of blood transfusion with an unstandardized mean difference (UMD) of 29.27 min (95% CI 5.24, 53.50) and 0.89 units (95% CI 0.52, 1.25). The lowest incidence of general complications, wound complications and late complications of PCCP was 0.09 (95% CI 0.04, 0.18), 0.01 (95% CI 0.01, 0.04) and 0.05 (95% CI 0.02, 0.11), respectively, when compared to others. The lowest fluoroscopic time was with DHS with an UMD of 0.24 min (95% CI 0.16, 0.32), whereas the lowest blood loss and shortest hospital stay were with PFN with an UMD of 233.61 ml of blood loss (95% CI 153.17, 314.04) and 7.23 days of hospital stay (95% CI 7.15, 7.31) when compared to all other fixation methods. Reoperation rates of all implants had no statistically significant difference. The network meta-analysis suggested that fixation with PCCP significantly shortens operative time and decreases the units of blood transfusion required, while also lowering risks of general complications, wound complications and late complications when compared to fixation. Use of PFN showed the least intra-operative blood loss and shortest hospital stay. Multiple active treatment comparisons indicate that PCCP fixation in trochanteric fractures in the elderly is the treatment of choice in terms of intra-operative outcomes and postoperative complications.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials

Arirachakaran

Amphansap

Thanindratarn

et al. 2017

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

“…Orthopedic complications and reoperation rates remain between 5% and 30% in the literature. [19,20] The present study demonstrated that the mortality, orthopedic complications, and reoperation rates in groups were similar and consistent with the literature.…”

Section: Discussionsupporting

confidence: 90%

Which implant is superior for treating simple pertrochanteric fractures of the proximal femur in the elderly patients?

Talmaç¹

2019

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND:The aim of this study was to compare the clinical and radiological results of the proximal femoral nail antirotation (PFNA) with those of the dynamic hip screw (DHS) and percutaneous compression plate (PCCP) in the treatment of simple pertrochanteric fractures. METHODS:A total of 203 patients were included in the study. PFNA fixations were performed in 73 patients (PFNA group), DHS in 68 patients (DHS group), and PCCP in 62 patients (PCCP group). The main outcome measurements were perioperative properties, the Harris hip score, changes in the neck-shaft angle, and loss of the abductor muscle strength. Data were compared between the groups. RESULTS:The mean estimated total blood loss and the number of patients receiving the blood transfusion rate in the PFNA group were statistically significantly lower. The mean operation and fluoroscopy times in the PCCP group were statistically significantly higher. The mean loss of the abductor muscle strength and changes in the neck-shaft angle in the PFNA group were statistically significantly higher. The mean Harris hip scores were similar. CONCLUSION:Our findings demonstrated that although PFNA was superior with regard to the perioperative data, DHS and PCCP were superior in maintaining the reduction and the abductor muscle strenght. All three implants were similar and had satisfactory functional outcomes.

show abstract

“…14,16 Some clinical studies have shown that DHS is good for stable fractures but is not an ideal method for unstable fractures treatment. [17][18][19][20] The Intertrochanteric fractures are fractures of elderly. Moran et al 21 in a mega study of 2903 cases, reported the mean age of 80 years for hip fractures.…”

Section: Discussionmentioning

confidence: 99%

Inter-Trochanteric Fractures;

Alam¹,

Jabeen

2019

TPMJ

View full text Add to dashboard Cite

ABSTRACT… Introduction: Hip fractures are a leading cause of death and disability among elderly. Approximately half of these injuries are intertrochanteric fractures and the incidence is continuously increasing. These fractures are the most common injuries around the hip region and are more common in elderly people. Different types of implants were tried at different times for internal fixation of these fractures, of which dynamic hip screw has remained the most popular one. But with the advent of some newer implants, the efficacy of dynamic hip screw is being questioned. Objectives: To determine the results of dynamic hip screw as a method of internal fixation in closed stable as well as unstable intertrochanteric fractures of femur in adults. Design: Descriptive case series. Setting: The study was conducted in orthopedic department Allied Hospital Faisalabad. Period: 11months (from 26 th , march, 2015 to 25 th Feb, 2016). Subjects and Methods: Sixty cases of intertrochanteric fractures were included and operated for internal fixation with dynamic hip screw under fluoroscopic guidance. Pre, per and post-operative findings during hospital stay and follow-up period were recorded. Results: We had a total 60 cases, 20 patients in group A stable intertrochanteric fractures and 40 patients in group B unstable intertrochanteric fractures. We have reported the follow up study up to 20 weeks. There were 10 (50%) male and 10 (50%) female in group A. In group B 27 (67.5%) males and 13 (32.5%) females. The youngest pt was 25 years in group A and 16 years in group B. The mean age in group A was 59.10 and st/deviation 16.942. In group B mean age was 54.85 and st/ deviation 14.123. Infection rate in group A was 5%. In group B superficial infection was 5% and deep infection was 2.5%. Nonunion in both groups was 5%. The failure rate was 5% in group A and 20% in group B. Conclusion: The use of Dynamic hip screw with aside plate is associated with good results and acceptable complication rate. Dynamic hip screw is implant of choice in both stable and unstable intertrochanteric fractures.

show abstract

Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Cited by 10 publications

References 50 publications

Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials

Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials

Which implant is superior for treating simple pertrochanteric fractures of the proximal femur in the elderly patients?

Inter-Trochanteric Fractures;

Contact Info

Product

Resources

About