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Meta-Analysis
. 2020 Aug 26;15(1):352.
doi: 10.1186/s13018-020-01842-z.

Dynamic hip screws versus cannulated screws for femoral neck fractures: a systematic review and meta-analysis

Lang Li  1 , Xue Zhao  2 , Xiaodong Yang  1 , Xueyang Tang  1 , Ming Liu  3
Affiliations
Meta-Analysis

Dynamic hip screws versus cannulated screws for femoral neck fractures: a systematic review and meta-analysis

Lang Li et al. J Orthop Surg Res. .

Abstract

Objective: Dynamic hip screw (DHS) and cannulated screws (CS) are widely used for femoral neck fractures. However, there is no definite result as to which surgical method bring less complications. We performed this study to compare the complication (mortality, non-union, avascular necrosis (AVN), and revision) of DHS and CS for the treatment of femoral neck fractures patients.

Methods: We searched Pubmed, Ovid, Cochrane Central Register of Controlled Trials, and other relevant studies related the comparison of DHS versus CS for femoral neck fractures from inception to Jan 7, 2020. The quality of the included randomized controlled trials (RCTs) and retrospective studies were assessed using the Cochrane Collaboration tool and Newcastle-Ottawa (NOS), respectively. The meta-analysis was performed by the RevMan 5.2 software.

Results: Nine RCTs and seven retrospective cohort studies were included for meta-analysis. CS was found to be superior to DHS with respect to AVN rate (OR 1.47; 95% CI 1.08-1.99; p = 0.01, I2 = 0%). There were no significant between-group differences with respect to mortality, non-union, and revision (p > 0.05).

Conclusion: DHS and CS have similar complication including mortality, revision rate, and non-union, but CS has superior to DHS on ANV. However, further studies are required to provide more robust evidence owing to some limitations.

Keywords: Cannulated screws; Dynamic hip screw; Femoral neck fractures; Meta-analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the selection process of the studies included for the meta-analysis
Fig. 2
Fig. 2
Quality assessment of risk of bias in the studies included
Fig. 3
Fig. 3
Forest plot of odds ratio with confidence intervals for mortality
Fig. 4
Fig. 4
Forest plot of odds ratio with confidence intervals for non-union
Fig. 5
Fig. 5
Forest plot of odds ratio with confidence intervals for AVN. a meta-analysis of AVN. b sensitive analysis of AVN
Fig. 6
Fig. 6
Forest plot of odds ratio with confidence intervals for revision
Fig. 7
Fig. 7
Publication bias of mortality
See this image and copyright information in PMC

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