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. 2017 Oct 12;7(1):13103.
doi: 10.1038/s41598-017-13377-1.

Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials

Bin-Fei Zhang  1 , Peng-Fei Wang  1 , Hai Huang  1 , Yu-Xuan Cong  1 , Hu Wang  1 , Yan Zhuang  2
Affiliations

Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials

Bin-Fei Zhang et al. Sci Rep. .

Abstract

Displaced intracapsular femoral neck (AO type 31 B2/3) fractures have various treatments, including internal fixation (IF), unipolar uncemented hemiarthroplasty (HA), bipolar uncemented HA, unipolar cemented HA, bipolar cemented HA, uncemented total hip replacement (THR), and cemented THR. Systematic literature retrieval was performed from the databases to compare them in a network meta-analysis. Forty studies (85 arms) containing 6141 patients were included. Overall, our network meta-analysis rank the orders of 7 procedures in reoperation, mortality, dislocation and infection, which indicates that IF may provide the highest reoperation incidence, unipolar cemented HA may provide the lowest reoperation incidence; uncemented THR contributes the highest dislocation incidence; and bipolar uncemented HA provides the lowest infection incidence. No differences in mortality were observed among the treatments. This conclusion is indirect; higher-quality direct comparisons are required.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flowchart of studies included in the meta-analysis.
Figure 2
Figure 2
Direct comparisons in the network model.
Figure 3
Figure 3
Contribution of the direct estimates effect of each pair in the entire network for reoperation (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 4
Figure 4
Inconsistency in the closed loops of reoperation. (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 5
Figure 5
Contribution of the direct estimates effect of each pair in the entire network for mortality (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 6
Figure 6
The inconsistency in closed loops of mortality (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 7
Figure 7
Contribution of the direct estimates effect of each pair in the entire network for infection (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 8
Figure 8
Inconsistency in closed loops of infection (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 9
Figure 9
Contribution of the direct estimates effect of each pair in the entire network for dislocation (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
Figure 10
Figure 10
Inconsistency in closed loops of dislocation (IF, internal fixation; unipolar-cemented-HA, U-C-HA; unipolar-uncemented-HA, U-U-HA; bipolar-cemented-HA, B-C-HA; bipolar-uncemented-HA, B-U-HA; uncemented-THR, U-THR; cemented-THR, C-THR).
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