TY - JOUR
T1 - Sliding hip screws versus cancellous screws for femoral neck fractures: A systematic review and meta-analysis
AU - Shehata, Mohamed S. A.
AU - Aboelnas, Mohamed M.
AU - Abdulkarim, Ali N.
AU - Abdallah, Ahmed R.
AU - Ahmed, Hussien
AU - Holton, James
AU - Consigliere, Paolo
AU - Narvani, Ali A.
AU - Sallam, Asser A.
AU - Wimhurst, James A.
AU - Imam, Mohamed A.
PY - 2019/10
Y1 - 2019/10
N2 - Purpose: Both sliding hip screws (SHS) and cancellous screws are used in the surgical management of intracapsular femoral neck fracture. However, there is paucity of information as to which is the superior treatment modality. We performed this systematic review and meta-analysis study to compare the clinical outcomes of SHS and cancellous screws for the treatment of femoral neck fractures in adult patients. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL, up to December 2017. Randomized controlled trials (RCTs) directly comparing the clinical outcomes of SHS and cancellous screws for femoral neck fractures were retrieved with no language or publication year restrictions. Data retrieved included operative details, nonunion rate, avascular necrosis, reoperation, infection and mortality, hip pain, functional hip scores, and medical complications. These were pooled as risk ratio or mean difference (MD) with their corresponding 95% confidence interval (CI). Heterogeneity was assessed by Chi-square test. Results: Ten RCTs involving 1934 patients were included in the final analysis. The pooled estimate showed that the SHS group was associated with more intraoperative blood loss (MD = 110.01 ml, 95% CI [52.42, 167.60], p = 0.00002) than the cancellous screws. There was no significant difference in terms of operative time, postoperative hip function, nonunion, avascular necrosis, reoperation rate, infection, fracture healing, hip pain, medical complications, and mortality rate. Conclusion: Based on our study, the cancellous screws group was associated with less intraoperative blood loss in comparison with the SHS group. No other significant differences were found between the two interventions.
AB - Purpose: Both sliding hip screws (SHS) and cancellous screws are used in the surgical management of intracapsular femoral neck fracture. However, there is paucity of information as to which is the superior treatment modality. We performed this systematic review and meta-analysis study to compare the clinical outcomes of SHS and cancellous screws for the treatment of femoral neck fractures in adult patients. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL, up to December 2017. Randomized controlled trials (RCTs) directly comparing the clinical outcomes of SHS and cancellous screws for femoral neck fractures were retrieved with no language or publication year restrictions. Data retrieved included operative details, nonunion rate, avascular necrosis, reoperation, infection and mortality, hip pain, functional hip scores, and medical complications. These were pooled as risk ratio or mean difference (MD) with their corresponding 95% confidence interval (CI). Heterogeneity was assessed by Chi-square test. Results: Ten RCTs involving 1934 patients were included in the final analysis. The pooled estimate showed that the SHS group was associated with more intraoperative blood loss (MD = 110.01 ml, 95% CI [52.42, 167.60], p = 0.00002) than the cancellous screws. There was no significant difference in terms of operative time, postoperative hip function, nonunion, avascular necrosis, reoperation rate, infection, fracture healing, hip pain, medical complications, and mortality rate. Conclusion: Based on our study, the cancellous screws group was associated with less intraoperative blood loss in comparison with the SHS group. No other significant differences were found between the two interventions.
KW - Cancellous screws
KW - Femoral neck fractures
KW - Internal fixation
KW - Sliding hip screws
UR - http://www.scopus.com/inward/record.url?scp=85067067404&partnerID=8YFLogxK
U2 - 10.1007/s00590-019-02460-0
DO - 10.1007/s00590-019-02460-0
M3 - Review article
AN - SCOPUS:85067067404
VL - 29
SP - 1383
EP - 1393
JO - European Journal of Orthopaedic Surgery & Traumatology
JF - European Journal of Orthopaedic Surgery & Traumatology
SN - 1633-8065
ER -