Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials

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Chouhan Dushyant; MEENA SANJAY; Kamboj Kulbhushan; Meena Mukesh Kumar; Narang Amit; Sinha Siddhartha

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Journal: Bulletin of Emergency And Trauma Year:2020 | Volume:8 | Issue:2 Page(s): 56-61

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Title

Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials

Author(s)

Keywords

Intertrochanteric fractures

Intramedullary nail

Distal unlocking

Abstract

Objective: To compare the outcome of distal locked and unlocked Intramedullary nailing in patients with Intertrochanteric fractures through systematic review and meta-analysis of randomized and non-randomized clinical trials. Methods: Randomized or non-randomized controlled studies comparing the effects of unlocked and locked nails for treatment of Intertrochanteric fractures were searched using the search strategy of Cochrane collaboration up to April 2019. Four eligible studies involving 691 patients were included. Their methodological quality was assessed, and data were extracted independently for meta-analysis. Results: The results showed that the unlocked group has significantly less operative time (MD:-8. 08; 95%CI-11. 36 to-4. 79; p<0. 00001), fluoroscopy time (MD:-7. 09, 95%CI-7. 09 to-4. 79; p<0. 00001), length of incision (MD:-2. 50, 95%CI 2. 85 to-2. 14; p<0. 00001) than the locked group. The complication rate was significantly higher in the locking group (OR: 0. 55, 95%CI 0. 26 to 1. 15; p=0. 03). No significant differences were found in the Harris hip score between the two groups (MD: 0. 68, 95% CI-0. 83 to 2. 19, p<0. 08). Conclusion: The present meta-analysis suggests that Intramedullary nailing without distal locking is reliable and acceptable option for treating intertrochanteric fracture. The advantages are reduced operative time, decreased fluoroscopy time, smaller size of incision and decreased complication rate. However, owing to the low-quality evidence currently available, additional high quality Randomized controlled trials are needed to confirm these findings.

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References

Unlocked versus dynamic and static distal locked femoral nails in stable and unstable intertrochanteric fractures. A prospective study

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APA: Copy

Chouhan, Dushyant, MEENA, SANJAY, Kamboj, Kulbhushan, Meena, Mukesh Kumar, Narang, Amit, & Sinha, Siddhartha. (2020). Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials. BULLETIN OF EMERGENCY AND TRAUMA BEAT, 8(2), 56-61. SID. https://sid.ir/paper/335157/en

Vancouver: Copy

Chouhan Dushyant, MEENA SANJAY, Kamboj Kulbhushan, Meena Mukesh Kumar, Narang Amit, Sinha Siddhartha. Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials. BULLETIN OF EMERGENCY AND TRAUMA BEAT[Internet]. 2020;8(2):56-61. Available from: https://sid.ir/paper/335157/en

IEEE: Copy

Dushyant Chouhan, SANJAY MEENA, Kulbhushan Kamboj, Mukesh Kumar Meena, Amit Narang, and Siddhartha Sinha, “Distal Locked versus Unlocked Intramedullary Nailing in Intertrochanteric Fracture; A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Trials,” BULLETIN OF EMERGENCY AND TRAUMA BEAT, vol. 8, no. 2, pp. 56–61, 2020, [Online]. Available: https://sid.ir/paper/335157/en

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