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Comparison of effects of four treatment methods for unstable intertrochanteric fractures: A network meta-analysis
Wu-Bin Shu1, Xiao-Bo Zhang1, Hua-Ya Lu1
1Department of Orthopedics, Ningbo Yinzhou Second Hospital, Ningbo Zhejiang, 315100, China.
Purpose:
The optimal internal fixation device for unstable intertrochanteric fracture remains a matter of controversy. By performing network meta-analysis, we developed a ranking of the following four surgical methods: proximal femoral nail antirotation, InterTan nail, gamma nail (GN) and sliding hip screws. We compare the complication rates in patients with unstable intertrochanteric fractures.
Materials And Methods:
After an exhaustive search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials for relevant studies, randomized controlled trials meeting selection criteria were entered into our network meta-analysis. Statistical analyses were conducted using Stata software, version 13.0 (Stata Corporation, College Station, Texas, USA).
Results:
We included 12 randomized controlled trials. Compared to Sliding hip screw, there were no substantial differences in rates of complications in unstable intertrochanteric fractures patient undergoing various treatments (all p > 0.05). Nevertheless, the surface under the cumulative ranking curve (SUCRA) for GN (80.6%) was significantly higher than those of the other three methods.
Conclusion:
GN had the highest probability of reducing the total incidence of complications among the four interventions for treating unstable intertrochanteric fractures.
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