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Meta-Analysis
. 2014 Mar 10:2014:512512.
doi: 10.1155/2014/512512. eCollection 2014.

Percutaneous compression plate versus dynamic hip screw for treatment of intertrochanteric Hip fractures: a meta-analyse of five randomized controlled trials

Lei Zhang  1 , Jie Shen  2 , Shengpeng Yu  2 , Qiang Huang  2 , Zhao Xie  2
Affiliations
Meta-Analysis

Percutaneous compression plate versus dynamic hip screw for treatment of intertrochanteric Hip fractures: a meta-analyse of five randomized controlled trials

Lei Zhang et al. ScientificWorldJournal. .

Abstract

Background: Percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for the treatment of intertrochanteric fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus dynamic hip screw (DHS) fixation for intertrochanteric fractures.

Methods: All randomized controlled trials (RCT) that compared PCCP with DHS in treating adult patients with intertrochanteric fractures were included. Main outcomes were collected and analysed using the RevMan 5.1 version.

Results: Five trials met the inclusion criteria. Compared with DHS, PCCP had similar operation time (95% CI: -26.01~4.05, P = 0.15), length of hospitalization (95% CI: -1.79~1.25, P = 0.73), mortality (95% CI: 0.37~1.02, P = 0.06), incidence of implant-related complications (95% CI: 0.29~1.82, P = 0.49), and reoperation rate (95% CI: 0.41~3.05, P = 0.83). But blood loss (95% CI: -173.84~-4.81, P = 0.04) and transfusion need (95% CI: -0.53~-0.07, P = 0.01) significantly favored the PCCP.

Conclusions: The PCCP was associated with reduced blood loss and less transfusion need, but similar to DHS in other respects. Owing to the limitations of this systematic review, more high-quality RCTs are still needed to assess the clinical efficiency of PCCP.

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Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Methodological quality of included studies. This risk of bias tool incorporates assessment of randomization (sequence generation and allocation concealment), blinding (participants, personnel, and outcome assessors), completeness of outcome data, selection of outcomes reported, and other sources of bias. The items were scored with “yes,” “no,” and “unclear.”
Figure 3
Figure 3
Comparison of operation time between PCCP and DHS.
Figure 4
Figure 4
Comparison of blood loss between PCCP and DHS.
Figure 5
Figure 5
Comparison of transfusion units per person between PCCP and DHS.
Figure 6
Figure 6
Comparison of length of hospitalization between PCCP and DHS.
Figure 7
Figure 7
Comparison of implant-related complications between PCCP and DHS.
Figure 8
Figure 8
Comparison of reoperation between PCCP and DHS.
Figure 9
Figure 9
Comparison of mortality between PCCP and DHS.
Figure 10
Figure 10
Funnel plot for operation time and the rate of reoperation demonstrating the evidence of publication bias. Basic symmetry of the above two funnel plot suggested that the possibility of publication bias is small ((a) operation time and (b) reoperation).
See this image and copyright information in PMC

References

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