Anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures:A Meta-analysis

Ma Hong-liang; Peng Jun; Chen Yi

doi:10.3969/j.issn.2095-4344.2013.43.016

Abstract：BACKGROUND:There is no consensus on the choice of anatomic plate or dynamic hip screw for the treatment of intertrochanteric fracture. Current research is limited to smal-sample studies, and it is difficult to carry out a large-sample multicenter analysis. OBJECTIVE:To carry out Meta-analysis about the literature on anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures, in order to evaluate the efficacy of anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures. METHODS:The PubMed database (1995-2013), EMCC database (1995-2013), CBM database (1995-2013), CNKI database (1995-2013), VIP database (1989-2013) and Wanfang database (1995-2013) were searched by computer to col ect the control ed trials of anatomic plate versus dynamic hip screw for the treatment of intertrochanteric fractures. Then, the retrieved studies were screened according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated to extract useful y data, and Meta-analysis was performed by using the RevMan5.0 software. RESULTS AND CONCLUSION:A total of 19 control ed trials were included with a total of 1 730 cases. Among them, 764 cases were belonged to the anatomic plate group, and dynamic hip screw group included 966 cases. The Meta-analysis results indicated that there were no statistical y significant differences in fracture healing time, prognosis excellent and good rate and postoperative complications between two groups (P=0.34, 0.58, 0.80);the operative time, intraoperative blood loss and postoperative drainage volume in the anatomic plate group were lower than those in the dynamic hip screw group (P<0.000 01). The results indicate that anatomic plate and dynamic hip screw have the similar clinical efficacy for the treatment of intertrochanteric fractures, but the anatomical plate has relatively simple operation and less bleeding. Due to the poor quality of the included literatures and high bias occur and influence the effect, so more wel-designed multi-center randomized control ed trials should be performed to provide high-quality evidence.