Meta-analysis of cement-augmented versus conventional proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly
ZHAO Liang
FEI Lincong
ZHENG Xuzhou
SHEN Juncheng
XU Xuepeng
YE Junwu
Abstract：Objective To systematically evaluate the clinical efficacy of cement-augmented proximal femoral nail anti-rotation(PFNA)compared with conventional PFNA in the treatment of intertrochanteric fractures in elderly patients.Methods Relevant studies comparing cement-augmented PFNA(augmentation group)with conventional PFNA(control group)for intertrochanteric fractures in elderly patients were retrieved from CNKI,WanFang,VIP,SinoMed,PubMed,Embase,and The Cochrane Library.Both randomized controlled trials(RCTs)and non-randomized controlled studies(nRCTs)were included.The Cochrane risk of bias tool was applied for RCTs,while the Newcastle-Ottawa Scale was used for nRCTs.The search covered January 2015 to January 2024.Data were analyzed using RevMan 5.3 software.Results A total of 16 studies were included(8 RCTs and 8 nRCTs).Meta-analysis demonstrated that the augmentation group had significantly shorter time to early postoperative weight-bearing(MD=-3.54,95%CI:-4.37--2.71),shorter fracture healing time(MD=-2.22,95%CI:-3.89--0.55),higher Harris hip scores at 3 months(MD=6.11,95%CI:2.29-9.94)and 6 months postoperatively(MD=6.07,95%CI:5.33-6.80),lower overall complication rate(RR=0.30,95%CI:0.18-0.48)and longer operative time(MD=5.39,95%CI:2.43-8.34)compared with the control group(all P<0.01).No significant differences were observed between groups in intraoperative blood loss(MD=0.09,95%CI:-5.81-5.35,P=0.97)or length of hospital stay(MD=-1.70,95%CI:-3.86-0.45,P=0.12).Conclusion Com-pared with conventional PFNA,cement-augmented PFNA can accelerate early postoperative weight-bearing and fracture healing,improve hip function at 3 and 6 months,and reduce the overall incidence of postoperative complications in elderly patients with intertrochanteric fractures.
Keywords：bone cementproximal femoral nail anti-rotationfemoral intertrochanteric fractureMeta-analysis
Publication Date：2025-10-25
Online Publishing Date：2025-11-11(First online date of this platform, not the publication date of the document)
Pages：7( 38-44 )