Internal Fixation Versus Arthroplasty for the Treatment of Nondisplaced Femoral Neck Fractures in the Elderly: A Systematic Review and Meta-Analysis.
| Title: | Internal Fixation Versus Arthroplasty for the Treatment of Nondisplaced Femoral Neck Fractures in the Elderly: A Systematic Review and Meta-Analysis. |
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| Authors: | Richards JT; Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD; and.; Overmann AL; Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD; and.; O'Hara NN; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.; D'Alleyrand JC; Department of Orthopaedic Surgery, Uniformed Services University-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD; and.; Slobogean GP; Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD. |
| Source: | Journal of orthopaedic trauma [J Orthop Trauma] 2020 Jan; Vol. 34 (1), pp. 42-48. |
| Publication Type: | Journal Article; Meta-Analysis; Systematic Review |
| Language: | English |
| Journal Info: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8807705 Publication Model: Print Cited Medium: Internet ISSN: 1531-2291 (Electronic) Linking ISSN: 08905339 NLM ISO Abbreviation: J Orthop Trauma Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hagerstown, MD : Lippincott Williams & Wilkins; Original Publication: [New York, N.Y.] : Raven Press, [c1987- |
| MeSH Terms: | Femoral Neck Fractures*/surgery ; Arthroplasty, Replacement, Hip* ; Hemiarthroplasty*; Aged ; Fracture Fixation, Internal ; Humans ; Length of Stay ; Reoperation ; Treatment Outcome |
| Abstract: | Objective: To compare the outcomes of elderly patients with nondisplaced and minimally displaced femoral neck fractures treated with internal fixation versus arthroplasty.; Data Sources: A comprehensive search of the MEDLINE, Embase, and central databases was conducted through June 25, 2019.; Study Selection: Studies were included if the sample population was (1) 60 years of age or older, (2) had nondisplaced or minimally displaced (Garden I or II) femoral neck fractures, and (3) if the study compared internal fixation versus arthroplasty. Only full-text English manuscripts were included. The primary outcome was reoperation. Secondary outcomes included mortality, patient-reported outcomes, length of hospital stay, infection, and blood transfusions.; Data Extraction: Two authors independently extracted data from the included studies. Each study was independently evaluated for quality using the Cochrane risk of bias assessment.; Data Synthesis: Of the 1597 identified articles, 4 manuscripts met the eligibility criteria with a total of 579 patients (236 treated with hemiarthroplasty and 343 treated with internal fixation). Patients treated with arthroplasty had a significantly lower risk of reoperation when compared with those treated with internal fixation [relative risk: 0.30 (95% CI, 0.16-0.55, P < 0.01)]. There was no significant difference detected in 1-year mortality risk between the 2 treatment groups.; Conclusions: In elderly patients with nondisplaced and minimally displaced femoral neck fractures, treatment with hemiarthroplasty may reduce the relative risk of reoperation by 70% when compared with internal fixation.; Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
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| Entry Date(s): | Date Created: 20191115 Date Completed: 20210621 Latest Revision: 20210621 |
| Update Code: | 20260130 |
| DOI: | 10.1097/BOT.0000000000001656 |
| PMID: | 31725086 |
| Database: | MEDLINE |
Journal Article; Meta-Analysis; Systematic Review