SynthesisActa orthopaedica et traumatologica turcica2020
Intramedullary versus extramedullary fixation in the treatment of subtrochanteric femur fractures: A comprehensive systematic review and meta-analysis.
Synthesis in Acta orthopaedica et traumatologica turcica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Intramedullary nail design for Thais with novel multi-femur shape optimization approach.Scientific reports · 2026Article
- Application of a self-developed femoral artery compression hemostasis device in proximal femoral nail anti-rotation surgery for intertrochanteric fractures: a case report.Frontiers in surgery · 2026Article
- Differences Between Atypical and Typical Subtrochanteric Fractures Due to Low-Energy Trauma.Cureus · 2025Article
- Emergency management of profunda femoris artery rupture caused by subtrochanteric femoral fracture: A rare case report.Medicine · 2025Article
- Is immediate weight bearing safe for subtrochanteric femur fractures in elderly patients treated by cephalomedullary nailing? A multicentric study in one hundred eighty-two patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Functional and Radiological Results Following Revision Blade Plating and Cephalomedullary Nailing in Aseptic Trochanteric and Subtrochanteric Nonunion.Journal of clinical medicine · 2024Article
- What is the Optimal Nail Length to Treat Osteoporotic Subtrochanteric Fractures? A Finite Element Analysis.Clinics in orthopedic surgery · 2024Article
- Blocking screw (pin) technique to achieve an acceptable reduction in intramedullary of subtrochanteric femoral fractures: indications, techniques, and clinical outcomes.Archives of orthopaedic and trauma surgery · 2024Article
- Effect of different internal fixation devices on intertrochanteric fractures.American journal of translational research · 2024Article
- Reconstruction intramedullary nailing for a failed subtrochanteric Seinsheimer type IIB fracture: a case report.Frontiers in surgery · 2023Article
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Authors and funding
4 authors.
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Abstract
objectiveThis meta-analysis aimed to compare the clinical outcomes of intramedullary fixation with the extramedullary fixation in the surgical management of subtrochanteric fractures by analyzing relevant randomized controlled trials (RCTs) and retrospective cohort studies (RCSs).
methodsThe PubMed, Embase, Cochrane Library, Wanfang database, and Chinese National Knowledge Infrastructure (CNKI) were searched from their inception till June 29, 2020. Two reviewers extracted the data, including operation time, intraoperative blood loss, fluoroscopy time, length of stay, union time, nonunion rate, infection rate, implant failure rate, reoperation rate, Harris hip score, and mortality rate. The Cochrane risk-of-bias tool and the Newcastle-Ottawa quality assessment scale were used to evaluate the methodological quality of RCTs and RCSs, respectively. Statistical heterogeneity was quantitatively evaluated with the I2 statistic.
resultsThere were no significant differences in operation time, intraoperative blood loss, average length of stay in hospital, infection rate, implant failure rate, Harris hip scores, and mortality rate. Intramedullary nail could achieve shorter union time (MD=-1.77, 95% CI -3.40~-0.14, p=0.03), lower nonunion rate (RR=0.36, 95%CI 0.14~0.97, p=0.04), and reoperation rate (RR=0.46, 95% CI 0.24~0.89, p=0.02) than extramedullary fixations. The subgroup analysis indicated that intramedullary nail was superior than extramedullary fixations in operation time, reoperation rate, and Harris hip scores in the ≥60-year subgroup. However, the intraoperative blood loss in intramedullary nail group was significantly higher than that of extramedullary fixation group in the <60-year subgroup.
conclusionThe results of this study have revealed that intramedullary fixation can confer shorter union time, lower nonunion, and reoperation rates compared with extramedullary fixations. Therefore, intramedullary fixation should be considered as the first selection for the treatment of patients with subtrochanteric fractures. LEVEL OF EVIDENCE: Level II, Therapeutic study.
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