title: A meta-analysis of percutenous compression plate versus intramedullary nail for treatment of intertrochanteric HIP fractures.
abstract: BACKGROUND
  Intertrochanteric hip fracture is associated with increased morbidity. Currently, a dramatic change in practice was demonstrated, with the intramedullary fixation rate increasing, despite a lack of evidence in the literature supporting the change. As a minimally invasive technique, percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for treatment of intertrochanteric hip fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus intramedullary nail (IMN) fixation for intertrochanteric fractures.
  
  
  METHODS
  A comprehensive search of related literature was conducted to identify all articles in Medline, Embase, Scopus, Research Gate, and the Cochrane Central Register of Controlled Trials published on or between January 1998 and January 2016. All studies that compared PCCP with IMN in treating adult patients with intertrochanteric fractures were included. Main outcomes about the two fixation method were collected and analysised using the Review Manager 5.1 provided by The Cochrane Collaboration.
  
  
  RESULTS
  Six trials involving 908 fractures met the inclusion criteria. Compared with IMN, PCCP had similar operation time, intraoperative blood loss, mortality, system complications, function score, function recovery, and reoperation rate (P > 0.05). But hospital stay, transfusion need, and incidence of implant-related complications significantly favored the PCCP (P < 0.05).
  
  
  CONCLUSIONS
  The PCCP was associated with less transfusion need, reduced hospital stay, and fewer incidence of implant-related complications compared with IMN. Although a change in practice was occurred, the patients treated with IMN seemed to face the potential for more complications. Owing to the limitations of this systematic review, more high-quality randomized controlled trials (RCTs) are still needed to confirm this conclusion.
authors.affiliation: National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Orthopaedics, The 101th Hospital of PLA, No. 101 Xingyuan Road, Wuxi, Jiangsu Province 214000, PR China.
authors.forename: Chao
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Orthopaedics, Dujiangyan Medical Center, Dujiangyan, Sichuan Province 611830, PR China.
authors.forename: Shengpeng
authors.initials: S
authors.lastname: Yu
authors.affiliation: National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China.
authors.forename: Ke
authors.initials: K
authors.lastname: Huang
authors.affiliation: National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China. Electronic address: xiezhao54981@163.com.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Xie
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D001858:Bone Nails / Q000706:statistics & numerical data*; D001860:Bone Plates / Q000706:statistics & numerical data*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: IMN; Intertrochanteric hip fracture; Intramedullary nail; Meta-analysis; PCCP; Percutaneous compression plate