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Meta-Analysis
. 2023 Apr 13;24(1):285.
doi: 10.1186/s12891-023-06378-x.

Comparison of femoral neck system versus cannulated screws for treatment of femoral neck fractures: a systematic review and meta-analysis

Jiabao Jiang #  1 , Jialei Chen #  2 , Fei Xing  1 , Hao Liu  1 , Zhou Xiang  1
Affiliations
Meta-Analysis

Comparison of femoral neck system versus cannulated screws for treatment of femoral neck fractures: a systematic review and meta-analysis

Jiabao Jiang et al. BMC Musculoskelet Disord. .

Abstract

Background: Recently, some studies on the efficacy of the femoral neck system (FNS) in treating femoral neck fractures (FNFs) have been published. Therefore, a systematic review was performed to clarify the efficacy and safety of FNS versus cannulated screws (CS) for the treatment of FNFs.

Method: The PubMed, EMBASE, and Cochrane databases were systematically searched for studies comparing FNS and CS fixations in FNFs. Intraoperative indicators, postoperative clinical indicators, postoperative complications, and postoperative scores were compared between the implants.

Results: A total of eight studies were included in the study, involving 448 FNFs patients. The results showed that patients in FNS group were significantly lower than the CS group in the number of X-ray exposures (WMD = -10.16; 95% CI, -11.44 to -8.88; P < 0.001; I2 = 0%), fracture healing time (WMD = -1.54; 95% CI, -2.38 to -0.70; P < 0.001; I2 = 92%), length of femoral neck shortening (WMD = -2.01; 95% CI, -3.11 to -0.91; P < 0.001; I2 = 0%), femoral head necrosis (OR = 0.27; 95% CI, 0.08 to 0.83; P = 0.02; I2 = 0%), implant failure/cutout (OR = 0.28; 95% CI, 0.10 to 0.82; P = 0.02; I2 = 0%), and Visual Analog Scale Score (WMD = -1.27; 95% CI, -2.51 to -0.04; P = 0.04; I2 = 91%). And the Harris Score was significantly higher in the FNS group than in the CS group (WMD = 4.15; 95% CI, 1.00 to 7.30; P = 0.01; I2 = 89%).

Conclusions: Based on this meta-analysis, FNS shows better clinical efficacy and safety in treating FNFs compared to CS. However, due to the limited quality and number of included studies and the high heterogeneity of the meta-analysis; large samples and multicenter RCTs are needed to confirm this conclusion in the future.

Level of evidence: II, Systematic review and Meta-analysis.

Trial registration: PROSPERO CRD42021283646.

Keywords: Cannulated screw; Femoral neck fracture; Femoral neck system; Internal fixation; Systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram for the identification and selection of studies included in the meta-analysis
Fig. 2
Fig. 2
Forest plot of the intraoperative indicators between the FNS and cannulated screw groups. A Incision length. B Blood loss. C X-ray exposures. D Operation time
Fig. 3
Fig. 3
Forest plot of the postoperative clinical indicators between the FNS and cannulated screw groups. A Fracture healing time. B Hospital stay. C length of femoral neck shortening
Fig. 4
Fig. 4
Forest plot of the postoperative complications between the FNS and cannulated screw groups. A Nonunion/delayed union. B Femoral head necrosis. C Implant failure/cutout
Fig. 5
Fig. 5
Forest plot of the postoperative scores between the FNS and cannulated screw groups. A Visual Analog Scale Score. B Harris Score
See this image and copyright information in PMC

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