title: [Postoperative implant-related complications after treatment of intertrochanteric fracture by gamma nail or by sliding hip screw: a meta-analysis].
abstract: OBJECTIVE
  To evaluate and compare the postoperative implant-related complications after treatment of intertrochanteric fracture by gamma nail or by sliding hip screw.
  
  
  METHODS
  Literatures on randomized controlled trials (RCTs) of the postoperative implant-related complications after treatment of intertrochanteric fracture by gamma nail or by sliding hip screw published before the end of June 2007 were retrieved from Cochrane library, Medline, Embase databank, and Chinese Biomedical Database. Relevant articles were handsearched in several Chinese journals. Methodology quality of the trials was critically assessed and data on postoperative implant-related complications were extracted. The software RevMan4.2.10 provided by the Cochrane Collaboration was used for meta-analysis.
  
  
  RESULTS
  10 RCTs and 3 quasi-RCTs involving 1857 cases were included. The results of meta-analysis showed that gamma nailing significantly increased the rate of postoperative femoral shaft fractures [RR = 3.75, 95%CI (1.47, 9.55), P = 0.006]. However, there were no statistic differences in the rates of lag screw cut-out and total mechanical complications between gamma nail and sliding hip screw treatment.
  
  
  CONCLUSIONS
  Compared with sliding hip screw for intertrochanteric fractures, gamma nailing can lead to higher incidence of postoperative femoral shaft fractures. Fracture stability may influence the rate of postoperative implant-related complications. Further large sample and high quality RCTs based on fracture stability are required in order to provide more sufficient and reliable evidence.
authors.affiliation: Department of Orthopedic Trauma, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Xiao-fei
authors.initials: XF
authors.lastname: Ding
authors.forename: Guo-xian
authors.initials: GX
authors.lastname: Pei
authors.forename: Jin
authors.initials: J
authors.lastname: Lin
authors.forename: Tai-xiang
authors.initials: TX
authors.lastname: Wu
mesh_terms: D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery; D016032:Randomized Controlled Trials as Topic