Internal Fixation Implants for Intracapsular Proximal Femoral Fractures in Adults

Overview

Journal Cochrane Database Syst Rev

Publisher Wiley

Specialties General Medicine
Health Services

Date 2001 Nov 1

PMID 11687113

Citations 29

Authors

M J Parker

G Stockton

Affiliations

Soon will be listed here.

Abstract

Background: Numerous different implants with screws, pins and side plates have been used for the internal fixation of intracapsular hip fractures.

Objectives: To determine from randomised trials which implant is superior for the internal fixation of intracapsular proximal femoral fractures.

Search Strategy: We searched the Cochrane Musculoskeletal Injuries Group specialised register. The date of the most recent search was December 2000.

Selection Criteria: Randomised and quasi-randomised trials comparing different implants for the internal fixation of intracapsular hip fractures in adults.

Data Collection And Analysis: Two reviewers independently assessed trial quality, by use of a ten item scale, and extracted data. Additional information was sought from trialists. After grouping by implant type, comparable groups of trials were subgrouped and where appropriate, data were pooled using the fixed effects model.

Main Results: Twenty-seven studies involving 5269 participants (5274 fractures) were included in the study. Considerable variation in the quality of methodology between studies was found and biases due to familiarity with some of the implants were noted. None of the implants tested were found to be significantly superior for any of the outcome measures related to fracture healing complications or mortality. The sliding hip screw was found to take longer to insert and to have an increased operative blood loss compared with multiple screws or pins.

Reviewer's Conclusions: No clear conclusions can be made on the choice of implant for internal fixation of intracapsular fractures from the available evidence within randomised trials.

Citing Articles

Risk assessment of femoral head AVN following reduction and fixation of intracapsular hip fractures in patients younger than 65 years over a 10 year follow up.

Benady A, Yehiel N, Efrima B, Abdellatif A, Vidra M, Khashan M Sci Rep. 2025; 15(1):5691.

PMID: 39962325 PMC: 11832920. DOI: 10.1038/s41598-025-89974-2.

Comparison of dynamic compression system versus multiple cancellous screws in the treatment of femoral neck fractures in young adults.

Aljasim O, Yener C, Ozkayin N J Orthop Surg Res. 2024; 19(1):422.

PMID: 39039508 PMC: 11265074. DOI: 10.1186/s13018-024-04913-7.

Low avascular necrosis rates in femoral neck fractures: efficacy of cannulated screw fixation.

Scattergood S, Berry A, Flannery O, Burdon A, Mitchell S, Fletcher J Eur J Orthop Surg Traumatol. 2024; 34(5):2565-2571.

PMID: 38698278 PMC: 11291580. DOI: 10.1007/s00590-024-03956-0.

Health economics for intra-capsular hip fractures undertaking fixation.

Wiik A, Ashdown T, Holloway I World J Orthop. 2024; 15(1):30-38.

PMID: 38293259 PMC: 10824066. DOI: 10.5312/wjo.v15.i1.30.

Pre-sliding of femoral neck system improves fixation stability in pauwels type III femoral neck fracture: a finite element analysis.

Cha Y, Chung J, Jung C, Kim J, Lee J, Yoo J BMC Musculoskelet Disord. 2023; 24(1):506.

PMID: 37344858 PMC: 10286416. DOI: 10.1186/s12891-023-06631-3.

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