Treatment of trochanteric fractures with proximal femoral nail antirotation or dynamic hip screw systems: a meta-analysis.
OBJECTIVE
A meta-analysis to compare the intraoperative and postoperative outcome data for the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) implant systems for the treatment of patients with trochanteric fractures.


METHODS
A detailed search of several electronic  databases was undertaken to identify randomized controlled trials published before 5 December 2011 that compared PFNA with DHS in patients with trochanteric fractures.


RESULTS
A quantitative meta-analysis of 11 studies including 798 patients was performed. PFNA was associated with significant  reductions in duration of surgery (weighted mean difference [WMD] -21.38 min; 95% confidence interval [CI] -33.50, -9.26 min), intraoperative blood loss (WMD -176.36 ml; 95% CI -232.20, -120.52 ml), rate of fixation failure (relative risk [RR] 0.27, 95%  CI 0.11, 0.62) and rate of postoperative complications (RR 0.46; 95% CI 0.31, 0.70) compared with DHS.


CONCLUSIONS
The use of PFNA for treatment of trochanteric fractures was found to be superior to DHS in terms of the duration of surgery, intraoperative blood loss, and rates of fixation failure  and overall complications.
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
C
C
Zeng
Y-R
YR
Wang
J
J
Wei
S-G
SG
Gao
F-J
FJ
Zhang
Z-Q
ZQ
Sun
G-H
GH
Lei
D001858:Bone Nails; D001863:Bone Screws; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications