Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Nov;97(47):e13001.
doi: 10.1097/MD.0000000000013001.

Is dynamic locking plate superior than other implants for intracapsular hip fracture: A meta-analysis

Tao Li  1 , Qing-Song Zhang
Affiliations
Review

Is dynamic locking plate superior than other implants for intracapsular hip fracture: A meta-analysis

Tao Li et al. Medicine (Baltimore). 2018 Nov.

Abstract

Background: We studied the safety and efficacy of dynamic locking plate vs. other implants (cannulated cancellous screws [CCS] or sliding hip screw [SHS]) in patients undergoing intracapsular hip fracture (ICHF).

Methods: We searched Pubmed, Embase, Web of Science, Cochrane library and Google database from inception to March 25, 2018. We selected any studies comparing dynamic locking plate for treatment ICHF. Non-union rate, osteonecrosis rate, cutout rate, revision rate, the replacement rate, and Harris hip scores were the outcomes. Stata 12.0 was used for meta-analysis.

Results: Four studies involving 419 patients (143 patients in the dynamic locking plate group and 276 patients in the other implants group) were finally included. Compared with CCS or SHS, dynamic locking plate was associated with a reduction of nonunion rate, revision rate, replacement rate (P <.05). Furthermore, dynamic locking plate was also associated with an increase of the Harris hip scores (P <.05). There was no significant difference between the osteonecrosis rate and cutout rate (P >.05).

Conclusions: Current meta-analysis revealed that dynamic locking plate has a benefit role in improving postoperative clinical outcome than CCS or SHS in ICHF patients. Further high quality and large-scale randomized controlled trials (RCTs) are needed to further identify the efficacy of dynamic locking plate for ICHF.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
PRISMA flowchart for the included studies.
Figure 2
Figure 2
The risk of bias summary for the included studies.
Figure 3
Figure 3
The risk of bias graph for the included studies.
Figure 4
Figure 4
Forest plot comparing the nonunion rate between the 2 groups.
Figure 5
Figure 5
Forest plot comparing osteonecrosis rate.
Figure 6
Figure 6
Forest plot comparing cutout rate.
Figure 7
Figure 7
Forest plot comparing revision rate.
Figure 8
Figure 8
Forest plot that comparing the replacement rate.
Figure 9
Figure 9
Forest plot that comparing the Harris hip scores.
See this image and copyright information in PMC

References

    1. Holt G, Smith R, Duncan K, et al. Gender differences in epidemiology and outcome after hip fracture: evidence from the Scottish Hip Fracture Audit. J Bone Joint Surg Br 2008;90:480–3. - PubMed
    1. Holt G, Smith R, Duncan K, et al. Epidemiology and outcome after hip fracture in the under 65s-evidence from the Scottish Hip Fracture Audit. Injury 2008;39:1175–81. - PubMed
    1. Zhang BF, Wang PF, Huang H, et al. Interventions for treating displaced intracapsular femoral neck fractures in the elderly: a Bayesian network meta-analysis of randomized controlled trials. Sci Rep 2017;7:13103. - PMC - PubMed
    1. Cooper C, Campion G, Melton LJ., 3rd Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285–9. - PubMed
    1. Bartels S, Gjertsen JE, Frihagen F, et al. High failure rate after internal fixation and beneficial outcome after arthroplasty in treatment of displaced femoral neck fractures in patients between 55 and 70 years. Acta Orthop 2017;89:1–6. - PMC - PubMed

MeSH terms