title: Anterior approach versus posterior approach for Pipkin I and II femoral head fractures: A systemic review and meta-analysis.
abstract: OBJECTIVE
  We performed a meta-analysis, pooling the results from controlled clinical trials to compare the efficiency of anterior and posterior surgical approaches to Pipkin I and II fractures of the femoral head.
  
  
  METHODS
  Potential academic articles were identified from the Cochrane Library, Medline (1966-2015.5), PubMed (1966-2015.5), Embase (1980-2015.5) and ScienceDirect (1966-2015.5) databases. Gray studies were identified from the references of the included literature. Pooling of the data was performed and analyzed by RevMan software, version 5.1.
  
  
  RESULTS
  Five case-control trials (CCTs) met the inclusion criteria. There were significant differences in the incidence of heterotopic ossification (HO) between the approaches, but no significant differences were found between the two groups regarding functional outcomes of the hip, general postoperative complications, osteonecrosis of the femoral head or post-traumatic arthritis.
  
  
  CONCLUSIONS
  The present meta-analysis indicated that the posterior approach decreased the risk of heterotopic ossification compared with the anterior approach for the treatment of Pipkin I and II femoral head fractures. No other complications were related to anterior and posterior approaches. Future high-quality randomized, controlled trials (RCTs) are needed to determine the optimal surgical approach and to predict other postoperative complications.
  
  
  METHODS
  III.
authors: Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China.
authors: Chen-Guang
authors: CG
authors: Wang
authors: Department of Rehabilitation, Tianjin Hospital, Tianjin 300211, People's Republic of China.
authors: Yao-Min
authors: YM
authors: Li
authors: Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China.
authors: Hua-Feng
authors: HF
authors: Zhang
authors: Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China.
authors: Hui
authors: H
authors: Li
authors: Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, People's Republic of China. Electronic address: hansontijmu@gmail.com.
authors: Zhi-Jun
authors: ZJ
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005270:Femur Head / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000453:epidemiology; D055815:Young Adult
keywords: Anterior approach; Complication; Femoral head fracture; Meta-analysis; Posterior approach