title: Review: Minimally invasive versus conventional dynamic hip screw fixation in elderly patients with intertrochanteric fractures: a systematic review and meta-analysis.
abstract: The classic dynamic hip screw fixation of intertrochanteric fractures may be associated with significant blood loss and soft tissue damage, which may worsen existing comorbidities of frail elderly patients. Recently, minimally invasive dynamic hip screw (MIDHS) technique was developed for osteosynthesis of intertrochanteric fractures. A highly sensitive search strategy was used to identify all published randomized or quasi-randomized controlled trials (RCTs/ qRCTs) and comparative observational studies comparing the MIDHS technique with the conventional dynamic hip screw (CDHS) technique in patients with intertrochanteric fractures. A pooled estimate of effect size was produced using both random and fixed effects models. Four RCTs/qRCTs and 2 retrospective comparative studies were identified. The MIDHS technique resulted in less blood loss, shorter hospitalization, lower pain level, faster fracture healing, and better hip function when compared with the CDHS technique. There was no significance difference between the 2 groups with regard to postoperative complications and implant position. The MIDHS technique may achieve perioperative benefits when compared with the CDHS technique.
authors.affiliation: Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Cheng
authors.forename: Guoyou
authors.initials: G
authors.lastname: Zhang
authors.forename: Xianlong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D020127:Recovery of Function; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome