PDF(Pubmed)
Abstract：
UNASSIGNED: Intertrochanteric Femur Fractures (IFF) fixation could be done with short or long Cephalomedullary Nails (CMNs). Nevertheless, despite several studies in the literature, there has been a continued lack of consensus on which design of CMN is better than the other. Hence, the current review aimed to evaluate the evidence about short versus long CMNs for the fixation of IFF.
UNASSIGNED: PRISMA guidelines were followed, and the protocol for the study was registered to PROSPERO. Four databases, Medline/PubMed, Embase, Scopus, and Cochrane Library, were searched. A total of 31 studies with 6 randomized trials (RCTs) and 25 non-randomized studies were included. Demographic data, follow-up period, and primary and secondary outcomes were extracted and evaluated from each of the included studies; statistical analysis was done by Review Manager Software version 5.4.1.
UNASSIGNED: Fourteen thousand five hundred forty-seven patients were included in this review.
UNASSIGNED: Long CMNs showed statistically significant lower rates of ipsilateral shaft femur refracture (OR 1.60, 95% CI 1.14, 2.24, p = 0.007); however, the difference was not statistically significant between the two groups for mortality at 30 days and within 1 year.
UNASSIGNED: Statistically significant shorter duration of surgery (MD-17.83 (95% CI - 22.03, - 13.63, p < 0.05), less intra-operative blood loss (MD - 62.65, 95% CI - 97.13 to - 28.17, p = < 0.05), and lower blood transfusion rates (OR 0.71, 95% CI 0.62, 0.83, p < 0.05) for short CMNs; no statistically significant difference for the length of hospital stay, implant-related complications, overall complications, re-operation rates, fluoroscopy time, and functional outcome between two groups of CMNs was seen.
UNASSIGNED: With shorter operative time, lesser intra-operative blood loss, and lower postoperative transfusion rates for short CMNs, they have certain benefits over longer CMNs. However, more distal shaft femur fractures were seen in the shorter version of nail, which should be considered before offering these nails to a patient; careful and individualized postoperative weight-bearing protocol could minimize the same.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s43465-023-00915-5.
UNASSIGNED: PRISMA guidelines were followed, and the protocol for the study was registered to PROSPERO. Four databases, Medline/PubMed, Embase, Scopus, and Cochrane Library, were searched. A total of 31 studies with 6 randomized trials (RCTs) and 25 non-randomized studies were included. Demographic data, follow-up period, and primary and secondary outcomes were extracted and evaluated from each of the included studies; statistical analysis was done by Review Manager Software version 5.4.1.
UNASSIGNED: Fourteen thousand five hundred forty-seven patients were included in this review.
UNASSIGNED: Long CMNs showed statistically significant lower rates of ipsilateral shaft femur refracture (OR 1.60, 95% CI 1.14, 2.24, p = 0.007); however, the difference was not statistically significant between the two groups for mortality at 30 days and within 1 year.
UNASSIGNED: Statistically significant shorter duration of surgery (MD-17.83 (95% CI - 22.03, - 13.63, p < 0.05), less intra-operative blood loss (MD - 62.65, 95% CI - 97.13 to - 28.17, p = < 0.05), and lower blood transfusion rates (OR 0.71, 95% CI 0.62, 0.83, p < 0.05) for short CMNs; no statistically significant difference for the length of hospital stay, implant-related complications, overall complications, re-operation rates, fluoroscopy time, and functional outcome between two groups of CMNs was seen.
UNASSIGNED: With shorter operative time, lesser intra-operative blood loss, and lower postoperative transfusion rates for short CMNs, they have certain benefits over longer CMNs. However, more distal shaft femur fractures were seen in the shorter version of nail, which should be considered before offering these nails to a patient; careful and individualized postoperative weight-bearing protocol could minimize the same.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s43465-023-00915-5.
摘要：
■股骨粗隆间骨折（IFF）的固定可以用短或长的头髓内钉（CMNs）进行。然而，尽管文献中有几项研究，对于CMN的哪一种设计比另一种更好，一直缺乏共识。因此，本综述旨在评估用于IFF固定的短CMN和长CMN的证据.
■遵循了PRISMA指南，并且研究方案已注册到PROSPERO.四个数据库,Medline/PubMed，Embase,Scopus,和Cochrane图书馆,被搜查了。共纳入31项研究，6项随机试验（RCTs）和25项非随机研究。人口统计数据,随访期,从每个纳入的研究中提取并评估主要和次要结局;统计分析由ReviewManagerSoftware5.4.1版完成.
■这篇综述包括了一万四千五百四十七例患者。
■长CMNs显示同侧股骨干再骨折率显著较低(OR1.60,95%CI1.14,2.24,p=0.007)；然而，两组30日及1年内死亡率差异无统计学意义.
■在统计学上显着缩短手术时间（MD-17.83（95％CI-22.03，-13.63，p<0.05），术中失血减少（MD-62.65，95%CI-97.13至-28.17，p=<0.05），短CMNs的输血率较低（OR0.71，95％CI0.62，0.83，p<0.05）；住院时间无统计学差异，植入物相关并发症,整体并发症,再手术率，透视时间,观察到两组CMN之间的功能结局。
■手术时间更短，术中失血较少,短CMN术后输血率较低，它们比更长的CMN有一定的好处。然而,较短版本的钉中发现了更多的股骨远端骨折，在将这些指甲提供给患者之前，应该考虑这一点；仔细和个性化的术后负重方案可以最大程度地减少这种情况。
■在线版本包含补充材料，可在10.1007/s43465-023-00915-5获得。
■遵循了PRISMA指南，并且研究方案已注册到PROSPERO.四个数据库,Medline/PubMed，Embase,Scopus,和Cochrane图书馆,被搜查了。共纳入31项研究，6项随机试验（RCTs）和25项非随机研究。人口统计数据,随访期,从每个纳入的研究中提取并评估主要和次要结局;统计分析由ReviewManagerSoftware5.4.1版完成.
■这篇综述包括了一万四千五百四十七例患者。
■长CMNs显示同侧股骨干再骨折率显著较低(OR1.60,95%CI1.14,2.24,p=0.007)；然而，两组30日及1年内死亡率差异无统计学意义.
■在统计学上显着缩短手术时间（MD-17.83（95％CI-22.03，-13.63，p<0.05），术中失血减少（MD-62.65，95%CI-97.13至-28.17，p=<0.05），短CMNs的输血率较低（OR0.71，95％CI0.62，0.83，p<0.05）；住院时间无统计学差异，植入物相关并发症,整体并发症,再手术率，透视时间,观察到两组CMN之间的功能结局。
■手术时间更短，术中失血较少,短CMN术后输血率较低，它们比更长的CMN有一定的好处。然而,较短版本的钉中发现了更多的股骨远端骨折，在将这些指甲提供给患者之前，应该考虑这一点；仔细和个性化的术后负重方案可以最大程度地减少这种情况。
■在线版本包含补充材料，可在10.1007/s43465-023-00915-5获得。
