title: Is helical blade superior to screw design in terms of cut-out rate for elderly trochanteric fractures? A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  This meta-analysis was conducted to investigate whether helical blade implant system had advantages in terms of cut-out rate when compared to screw implant system for trochanteric fractures of elderly population.
  
  
  METHODS
  The databases of MEDLINE, Cochrane Library and OVID were searched from inception to September 2013, and all randomized controlled trials comparing outcomes between helical blade system and screw system in treating trochanteric fractures were selected. Three researchers assessed the methodological quality and extracted data of the enrolled studies independently. Data were analysed using Review Manager 5.1 version.
  
  
  RESULTS
  Six studies including 759 patients were involved. Results revealed that compared with screw group, blade group had similar outcomes of "centre-centre" position (95% CI 0.89-1.06, P = 0.48) and tip-apex distance (95% CI-0.08 to 1.31, P = 0.08). Cut-out and other complications were also comparable between the two groups (95% CI 0.34-1.54, P = 0.41; 95% CI 0.73-1.32, P = 0.90). Operation time and fluoroscopy time of blade group were significantly less than that of screw group (95% CI -5.13 to -3.70, P < 0.00001; 95% CI -32.50 to -27.07, P < 0.00001). Outcome of post-operative function was similar between two groups (95% CI 0.94-1.15, P = 0.45).
  
  
  CONCLUSIONS
  Blade group required less operation time and fluoroscopy time than that of screw group treating trochanteric fractures in the elderly, but the differences observed could be biased due to grouping and other limitations. Outcomes of cut-out complication, other complications, position of implant and post-operative function were similar between two groups.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, 37# Guoxue Rd, Chengdu, 610041, Sichuan, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Huang
authors.forename: Frankie
authors.initials: F
authors.lastname: Leung
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Long
authors.initials: L
authors.lastname: Chen
authors.forename: Zhao
authors.initials: Z
authors.lastname: Xu
authors.forename: Zhou
authors.initials: Z
authors.lastname: Xiang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome