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Short versus long intramedullary nails for intertrochanteric hip fracture: Meta-analysis
P Domenech1, G Mariscal1, V Marquina1
1Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, España; Department of Orthopedic Surgery and Traumatology, Valencia General University Hospital, Valencia, España.
Objective:
To compare short versus long intramedullary nails for intertrochanteric hip fractures in terms of efficacy and safety.
Methods:
We included cohort studies and randomized clinical trials. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using the Review Manager 5.4. Heterogeneity was checked with the I2 test. A fixed effects model was adopted if there was no heterogeneity.
Results:
Twelve studies were included. The reoperations rate was lower in the short nail group (OR: 0.58, 95%CI: 0.38-0.88) and there were no differences regarding the peri-implant fracture rate (OR: 1.77, 95%CI: 0.68-4.60). Surgery time and blood loss was significantly higher in the long nail group (MD: -12.44, 95%CI: -14.60 -10.28) (MD: -19.36, 95%CI: -27.24 -11.48). There were no differences in functional outcomes.
Conclusions:
The long nail showed a higher reoperation rate, blood loss and surgery time compared to the short nail.
Level Of Evidence:
III.
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