SynthesisOrthopaedic surgery2019
Hip Replacement as Alternative to Intramedullary Nail in Elderly Patients with Unstable Intertrochanteric Fracture: A Systematic Review and Meta-Analysis.
Synthesis in Orthopaedic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Intramedullary fixation versus arthroplasty in the treatment of geriatric trochanteric fractures: a systematic review and meta-analysis.BMC geriatrics · 2026Pooled it
- Association of bone mineral density with perioperative hidden blood loss in older adults undergoing intramedullary nailing for unstable intertrochanteric fractures.BMC geriatrics · 2026Article
- Hemiarthroplasty vs. proximal femoral nail fixation in unstable pertrochanteric fractures: an updated systematic review and meta-analysis.Frontiers in surgery · 2026Review
- Cementless Transtrochanteric Bipolar Hemiarthroplasty vs. Proximal Femoral Nailing for Unstable Intertrochanteric Fractures in the Elderly: A Retrospective Comparative Study.Journal of clinical medicine · 2025Article
- A Novel Interfragmentary Technique vs. A Conventional Posterolateral Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- A bone-conserving revision stem for unstable intertrochanteric fractures of the geriatric osteoporotic population.Arthroplasty (London, England) · 2022Article
- The effect of preexisting radiographic hip osteoarthritis on the functional recovery after surgical treatment of intertrochanteric fractures in elderly patients.Acta orthopaedica et traumatologica turcica · 2022Article
- A Retrospective Study of 98 Elderly Patients with High-Risk Lateral Femoral Wall Intertrochanteric Hip Fractures to Compare Outcomes Following Surgery with Proximal Femoral Nail Antirotation (PFNA) Versus Dynamic Hip Screw (DHS).Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly patients. The predictive value of the Charlson Comorbidity Index in 1-year mortality.Journal of clinical orthopaedics and trauma · 2022Article
- Extracapsular femoral neck fractures treated with total hip arthroplasty: identification of a population with better outcomes.Orthopedic reviews · 2022Article
- Article
- Intertrochanteric fractures treated by diaphyseal support arthroplasty with hook plate vs cerclage wires only: A retrospective cohort study.Annals of medicine and surgery (2012) · 2021Article
- ArthroplastyWorld journal of clinical cases · 2021Article
- Cemented hemiarthroplasty versus proximal femoral nail antirotation in the management of intertrochanteric femoral fractures in the elderly: a case control study.BMC musculoskeletal disorders · 2021Article
- Fixation of intertrochanteric femur fractures using the SIGN intramedullary nail augmented by a lateral plate in a resource-limited setting without intraoperative fluoroscopy: assessment of functional outcomes at one-year follow-up at Juba Teaching Hospital.OTA international : the open access journal of orthopaedic trauma · 2021Article
- Treatment of Intertrochanteric Femur Fractures with Hip Arthroplasty in Older Patients: A Narrative Review of Indications and Outcomes.Medicina (Kaunas, Lithuania) · 2021Review
- The Cost and Consequences of Failed Osteosynthesis of Intertrochanteric Femur Fractures: A Matched Cohort Study.Indian journal of orthopaedics · 2021Article
- X-Ray Film under Artificial Intelligence Algorithm in the Evaluation for Nursing Effect of Gamma Nail Internal Fixation in Elderly Patients with Intertrochanteric Fracture of Femur.Computational and mathematical methods in medicine · 2021Article
- Diagnostic Value of MRI Lamellated Hyperintense Synovitis in Periprosthetic Infection of Hip.Orthopaedic surgery · 2020Article
- Comparison of proximal femoral nail antirotation and total hip arthroplasty in the treatment of femoral intertrochanteric fracture.Pakistan journal of medical sciencesArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo evaluate the efficacy and safety of hip replacement and intramedullary nails for treating unstable intertrochanteric fractures in elderly patients.
methodsRandomized clinical trials (RCTs) to compare hip replacement with intramedullary nail in the management of elderly patients with unstable intertrochanteric femur fracture were retrieved from Cochrane Library (up to January 2018), CNKI (China National Knowledge Infrastructure), Wanfang Data, PubMed, and Embase. The methodological quality of the included trials was assessed using the Cochrane risk of bias assessment tool, and relevant data was extracted. Statistical analysis was performed by Revman 5.3. Where possible, we performed the limited pooling of data.
resultsFourteen trials including a total of 1067 participants aged 65 and above were included for qualitative synthesis and meta-analysis. The methodological quality of the included study was poor. The meta-analysis indicated that the hip replacement group benefited more than the intramedullary nail group in terms of the bearing load time (WMD -14.61, 95% CI -21.51 to -7.7, P < 0.0001), mechanical complications (OR 0.34, 95% CI 0.21 to 0.57, P < 0.0001), and post-operative complications (OR 0.46, 95% CI 0.22 to 0.93, P = 0.03). While the intramedullary nail was superior to arthroplasty regarding the intraoperative blood loss (WMD 58.36, 95% CI 30.77 to 85.94, P < 0.0001). However, there were no statistical significances in the length of surgery (WMD 5.27, 95% CI 4.23 to 14.77, P = 0.28), units of blood transfusion (WMD 0.34, 95% CI -0.16 to 0.85, P = 0.18), length of hospital stay (WMD -1.00, 95% CI -2.93 to 0.93, P = 0.31), Harris hip score (WMD 0.31, 95% CI -0.39 to 1.01, P = 0.38), and mortality (OR 1.24, 95% CI 0.12 to 13.10, P = 0.86).
conclusionsThis systematic review and meta-analysis provided evidence for the efficacy and safety of hip replacement and intramedullary nail in treating unstable intertrochanteric fractures. However, the results should be interpreted cautiously because of methodological limitations and publication bias.
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