title: Efficacies of surgical treatments based on Harris hip score in elderly patients with femoral neck fracture.
abstract: OBJECTIVE
  To compare the efficacies of four surgical treatments, i.e., total hip arthroplasty (THA), internal fixation (IF), hemiarthroplasty (HA), and artificial femoral head replacement (artificial FHR), by performing a network meta-analysis based on Harris hip score (HHS) in elderly patients with femoral neck fracture.
  
  
  METHODS
  In strict accordance with specific inclusion and exclusion criteria, randomized controlled trails (RCTs) were screened and selected from a larger group of studies that were retrieved through a comprehensive search of scientific literature databases, further complimented by manual search. The resultant high-quality data from final selected studies were analyzed using Stata 12.0 software.
  
  
  RESULTS
  A total of 3680 studies were initially retrieved from database search, and 15 RCTs were eventually incorporated into this meta-analysis, containing 1781 elderly patients who had undergone various surgical treatments for femoral neck fracture (THA group = 604; HA group = 604; IF group = 495; artificial FHR group = 78). Our major result revealed a statistically significant difference in HHS of femoral neck fracture when HA and IF groups were compared with THA. No differences were detected in the HHS of femoral neck fracture undergoing artificial FHR and THA. The surface under the cumulative ranking curves (SUCRA) value of HHS, in elderly patients with femoral neck fracture after surgery, revealed that IF has the highest value.
  
  
  CONCLUSIONS
  The current network meta-analysis results suggest that IF is the superlative surgical procedure for femoral neck fracture patients, and IF significantly improves the HHS in femoral neck fracture patients.
authors.affiliation: Department of Orthopedics, Shanghai Huadong Hospital Shanghai 200040, P. R. China.
authors.forename: Chengwei
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Orthopedics, Shanghai Huadong Hospital Shanghai 200040, P. R. China.
authors.forename: Fengjian
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, Shanghai Huadong Hospital Shanghai 200040, P. R. China.
authors.forename: Weilong
authors.initials: W
authors.lastname: Lin
authors.affiliation: Department of Orthopedics, Shanghai Huadong Hospital Shanghai 200040, P. R. China.
authors.forename: Yongqian
authors.initials: Y
authors.lastname: Fan
keywords: Femoral neck fracture; artificial femoral head replacement; hemiarthroplasty; internal fixation; randomized controlled trials; total hip arthroplasty