ABSTRACT
BACKGROUND:
Intertrochanteric fracture is one of the most common fractures in older
adults. The surgical
treatment methods include artificial
joint replacement (total
hip and
femoral head replacement) and internal fixation (proximal femoral
nail anti-
rotation and dynamic
hip screw), but there is no clear evidence to evaluate the effect of them.
OBJECTIVE:
To compare the effect difference of
arthroplasty and internal fixation in the
treatment of intertrochanteric fracture in the
elderly people.
METHODS:
We retrieved randomized controled studies on artificial
joint replacement (total
hip and
femoral head replacement) and internal fixation (proximal femoral
nail anti-
rotation and dynamic
hip screw) in the
treatment of intertrochanteric fracture from 1990 to 2015.
Meta-analysis was used to compare operation
time, intraoperative
bleeding volume, one-year postoperative Harris
hip scores, and one-year
postoperative complication between the
arthroplasty and internal fixation. RESULTS AND
CONCLUSION:
(1) Twenty-one studies were included. (2) Intraoperative
bleeding volume and one-year postoperative Harris
hip scores were higher in the
arthroplasty group than in the internal fixation group. (3) Operation
time was
similar between the
arthroplasty and internal fixation groups. (4) Complication rate was lower in the
arthroplasty group than in the internal fixation group.
Incidence of
complications was closed between the
arthroplasty and internal fixation groups. (5) Results suggested that the effect of
arthroplasty was better than internal fixation for treating intertrochanteric fracture in the
elderly. However, prospective large-sample long-term randomized controled trials are needed for verification.
