Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review

Abstract

Background Femoral neck fractures have a higher incidence in older people with poor prognosis, inducing serious social problems. Common treatment methods include total hip arthroplasty, bipolar hemiarthroplasty, double-screw fixation, multiple-screw fixation, and dynamic hip system. Methods We searched through four electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase databases, for articles regarding femoral neck fractures, bone screw, and hip prosthesis published up to February 11, 2020. All included articles were used for quality evaluation and data extraction. Extracted data were expressed as odds ratios or weighted mean differences, with 95% confidence intervals. We conducted a network meta-analysis for Harris hip score, complications, 1-year mortality rate, reoperation rate, intraoperative blood loss, and duration of operation using STATA version 16.0 software. Results Twenty-two randomized controlled trials and nine cohort studies included in this study involved 3861 patients. Total hip arthroplasty significantly improved the postoperative function of patients with femoral neck fractures. The surface under the cumulative ranking curve value of the Harris hip score for more than 1 year after total hip arthroplasty was 98.2. Conclusions This meta-analysis indicated no significant difference in mortality among different treatment groups. Total hip arthroplasty can provide satisfactory outcomes in hip joint function, and double-screw fixation results in the lowest intraoperative risk. In general, total hip arthroplasty results in a lower incidence of adverse events and is especially recommended for patients with femoral neck fractures. This article has been retrospectively registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) on November 27, 2020. Registration number: INPLASY2020110123.

Nomogram based on high-density lipoprotein cholesterol for the occurrence of preoperative deep vein thrombosis in patients with intertrochanteric femur fracture: a retrospective study

“…Patients with IFF need to stay in the hospital for an extended period of time, and they cannot return to their pre-fracture activities, joint function, or independent quality of life once they are discharged [ 4 ]. Patients with IFF have a much better prognosis after surgery [ 5 ], with two typical surgical techniques being intramedullary fixation using a proximal femoral nail system and extramedullary fixation using a plate system [ 6 – 8 ]. As the population ages, IFF is frequently associated with a number of serious side effects, such as deep vein thrombosis, nonunion of the fracture, and femoral head necrosis, which in extreme circumstances can be fatal [ 9 ].…”

Positive buttress reduction in femoral neck fractures: a literature review

“…Failure to achieve anatomical reduction can increase the risk of adverse events after surgery [ 13 – 16 ]. Unfortunately, postoperative complications such as nonunion, internal fixation failure, ONFH, infection, and nerve paralysis are common after FNFs reduction surgery, particularly in young people [ 17 ]. The risk of postoperative complications can increase if poor bone alignment is not detected.…”

Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis

“…[2][3][4] Hip surgery, including hip arthroplasty, hip fracture internal fixation and hip arthroscopy procedures, is the main treatments for hip diseases. [5][6][7][8] Hip surgery is often associated with moderate to severe postoperative pain, particularly in hip fracture patients undergoing surgical treatment and severe pain persists throughout the perioperative period. [9][10][11] As a minimally invasive approach, arthroscopic hip surgery is gaining popularity globally.…”