Implant-related complications in the treatment of unstable intertrochanteric fractures: meta-analysis of dynamic screw-plate versus dynamic screw-intramedullary nail devices.
The choice between dynamic screw-intramedullary nail (DSIN) devices and dynamic screw-plate (DSP) devices for the fixation of unstable trochanteric fractures remains controversial. This study presents a meta-analysis of fixation failures in unstable trochanteric femoral fractures using DSP devices or DSIN devices. Two independent assessors selected randomised controlled trials using a range of electronic databases, as well as reference lists of selected articles. A study quality checklist was used. The occurrence of fixation failure, in particular cut-out, was the primary subject of analysis using descriptive statistics and random-effect meta-analyses. Seventeen trials were identified. Meta-analyses showed no significant difference in the frequency of implant-related complications between the two types of devices. Iatrogenic femoral fractures associated with the use of DSIN devices represent a rare, but persistent, risk. There was a tendency for less frequent cut-out with intramedullary devices compared with DSP devices.
Audigé
L
L
AO Clinical Investigation and Documentation, AO ASIF Center, 7270 Davos Platz, Clavadelerstrasse, Switzerland. laurent.audige@ao-asif.ch
Hanson
B
B
Swiontkowski
M F
MF
D001858:Bone Nails; D001863:Bone Screws; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome