SynthesisJournal of orthopaedic surgery and research2023
Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients.
Synthesis in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses 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.
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Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Intramedullary fixation versus arthroplasty in the treatment of geriatric trochanteric fractures: a systematic review and meta-analysis.BMC geriatrics · 2026Pooled it
- Parallel versus non-parallel cannulated screw fixation for femoral neck fractures: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Neutrophil-to-lymphocyte ratio for predicting postoperative mortality after hip fracture surgery: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Effect of different types of internal fixation on the incidence of femoral head necrosis in adult femoral neck fractures: a single-arm rate and network meta-analysis.European journal of medical research · 2025Pooled it
- Patient-related Predictors for the Functional Outcome of SuperPATH Hemiarthroplasty versus Conventional Approach Hemiarthroplasty: A Systematic Review and Meta-regression Analysis of Randomized Controlled Trials.Orthopaedic surgery · 2024Pooled it
- Association between preoperative prognostic nutritional index and postoperative delirium in older adults with hip fractures: a real-world study.Annals of medicine · 2026Article
- Efficacy and safety of tranexamic acid in patients undergoing hip hemiarthroplasty: an updated systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2026Review
- Serial Presepsin Measurement as a Predictor of In-Hospital Mortality in Older Adults with Hip Fractures.Life (Basel, Switzerland) · 2026Article
- Does an Extended Offset Stem Improve Hip Stability and Function in Elderly Patients with a Femoral Neck Fracture?Clinics in orthopedic surgery · 2026Article
- Advances in internal fixation methods for intertrochanteric femoral fractures: A narrative review.Pakistan journal of medical sciences · 2026Review
- Navigation System-Assisted vs Freehand Cannulated Screw Fixation for Femoral Neck Fractures: Protocol for a Multicenter Randomized Controlled Trial.JMIR research protocols · 2026Article
- Electronic Medical Record Data-Based Analysis of Discharge Pathways and Functional Recovery by Surgical Procedure Among Patients with Hip-Related Fractures in a Convalescent Rehabilitation Hospital: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Biomechanical study of medial buttress plate combined with cannulated compression screws for pauwels type III femoral neck fractures using formalin-fixed human cadaveric femora.BMC musculoskeletal disorders · 2026Article
- Association of GLP-1 receptor agonist use with outcomes after surgical fixation of femoral neck fracture in patients with type 2 diabetes: a propensity score-matched analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Femoral Neck Fracture With Anterior Tilt.Orthopaedic surgery · 2026Article
- A Bayesian network meta-analysis of peripheral nerve blocks for postoperative analgesia in adults following hip fracture surgery.BMC surgery · 2026Article
- Femoral neck system vs. cannulated screws for Pauwels type III femoral neck fracture in non-elderly patients: a systematic review and meta-analysis.Frontiers in surgery · 2026Review
- Clinical Outcomes of the Cephalomedullary Nail with Supplementary Screws versus Multiple Cannulated Screws for Femoral Neck Fracture in Young and Active Patients.Hip & pelvis · 2025Article
- Article
- Bipolar hemiarthroplasty for femoral neck fractures in elderly patients: a retrospective study of 1001 patients.Archives of orthopaedic and trauma surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur aim was to determine the best operative procedure in human participants with a displaced or non-displaced femoral neck fracture comparing cannulated screw (CS) fixation, dynamic hip screw (DHS) fixation, hemiarthroplasty (HA), and total hip arthroplasty (THA) in terms of surgical and functional outcomes, reoperation and postoperative complications.
methodsWe searched PubMed, The Cochrane Library, Clinical trials, CINAHL, and Embase for randomized controlled trials (RCTs) or quasi-RCTs up to 31 July 2022. A frequentist network meta-analysis was performed to assess the comparative effects of the four operative procedures, using fixed-effects and random-effects models. Mean differences (MDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables.
resultsA total of 33 RCTs with 5703 patients were included in our network meta-analysis. CS fixation was best in terms of operation time (CS: MD = - 57.70, 95% CI - 72.78; - 42.62; DHS: MD = - 53.56, 95% CI - 76.17; - 30.95; HA: MD = - 20.90, 95% CI - 30.65; - 11.15; THA: MD = 1.00 reference) and intraoperative blood loss (CS: MD = - 3.67, 95% CI - 4.44; - 2.90; DHS: MD = - 3.20, 95% CI - 4.97; - 1.43; HA: MD = - 1.20, 95% CI - 1.73; - 0.67; THA: MD = 1.00 reference). In life quality and functional outcome, measured at different time points with EQ-5D and the Harris Hip Score (HHS), THA ranked first and HA second (e.g. EQ-5D 2 years postoperatively: CS: MD = - 0.20, 95% CI - 0.29; - 0.11; HA: MD = - 0.09, 95% CI - 0.17; - 0.02; THA: MD = 1.00 reference; HHS 2 years postoperatively: CS: MD = - 5.50, 95% CI - 9.98; - 1.03; DHS: MD = - 8.93, 95% CI - 15.08; - 2.78; HA: MD = - 3.65, 95% CI - 6.74; - 0.57; THA: MD = 1.00 reference). CS fixation had the highest reoperation risk, followed by DHS fixation, HA, and THA (CS: OR = 9.98, 95% CI 4.60; 21.63; DHS: OR = 5.07, 95% CI 2.15; 11.96; HA: OR = 1.60, 95% CI 0.89; 2.89; THA: OR = 1.00 reference).
conclusionIn our cohort of patients with displaced and non-displaced femoral neck fractures, HHS, EQ-5D, and reoperation risk showed an advantage of THA and HA compared with CS and DHS fixation. Based on these findings, we recommend that hip arthroplasty should be preferred and internal fixation of femoral neck fractures should only be considered in individual cases. LEVEL OF EVIDENCE I: a systematic review of randomized controlled trials.
trial registrationPROSPERO on 10 August 2022 (CRD42022350293).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.