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Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis

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ABSTRACT

The purpose of this study was to compare the outcomes focusing on the functional outcome and clinical results of replacement arthroplasty (AP) vs. internal fixation (IF) for the treatment of unstable intertrochanteric femoral fracture in elderly. Systematic review and meta-analysis were performed on 10 available clinical studies (2 randomized controlled trials and 8 comparative studies). Subgroup analysis was performed by type of methodological quality. Partial weight bearing time in AP group was earlier than that in IF group (SMD = −0.86; 95% CI = −0.42, 1.29; P = 0.050). The overall outcomes such as mortality, reoperation rate, and complication showed no significant diffrence between the 2 groups (AP vs. IF). Therefore, this systematic review demonstrates that AP provides superior functional outcomes especially earlier mobilization, as compared to IF in elderly patients with an unstable intertrochanteric femoral fracture.

No MeSH data available.


Related in: MedlinePlus

The forest plot of the outcomes comparing AP with IF. (A) Mortality. (B) Reoperation. (C) Complication-related medical condition. (D) Complication-related operation.AP = arthroplasty, IF = internal fixation, OR = odds ratio; CI = confidence interval, M-H = Mantal-Haenszel.
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Figure 2: The forest plot of the outcomes comparing AP with IF. (A) Mortality. (B) Reoperation. (C) Complication-related medical condition. (D) Complication-related operation.AP = arthroplasty, IF = internal fixation, OR = odds ratio; CI = confidence interval, M-H = Mantal-Haenszel.

Mentions: Mortality rate (Fig. 2A): 6 studies (161718202224) reported the mortality rate, a total of 914 participants with 462 patients assigned to the AP group and 452 patients assigned to the IF group. There was low evidence of heterogeneity across the studies (I2 = 0%; P = 0.480) and the fixed model was performed. There was no statistically difference between AP group and IF group (OR = 1.20; 95% CI = 0.83, 1.73; P = 0.330; number needed to treat [NNT] = −48).


Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis
The forest plot of the outcomes comparing AP with IF. (A) Mortality. (B) Reoperation. (C) Complication-related medical condition. (D) Complication-related operation.AP = arthroplasty, IF = internal fixation, OR = odds ratio; CI = confidence interval, M-H = Mantal-Haenszel.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383621&req=5

Figure 2: The forest plot of the outcomes comparing AP with IF. (A) Mortality. (B) Reoperation. (C) Complication-related medical condition. (D) Complication-related operation.AP = arthroplasty, IF = internal fixation, OR = odds ratio; CI = confidence interval, M-H = Mantal-Haenszel.
Mentions: Mortality rate (Fig. 2A): 6 studies (161718202224) reported the mortality rate, a total of 914 participants with 462 patients assigned to the AP group and 452 patients assigned to the IF group. There was low evidence of heterogeneity across the studies (I2 = 0%; P = 0.480) and the fixed model was performed. There was no statistically difference between AP group and IF group (OR = 1.20; 95% CI = 0.83, 1.73; P = 0.330; number needed to treat [NNT] = −48).

View Article: PubMed Central - PubMed

ABSTRACT

The purpose of this study was to compare the outcomes focusing on the functional outcome and clinical results of replacement arthroplasty (AP) vs. internal fixation (IF) for the treatment of unstable intertrochanteric femoral fracture in elderly. Systematic review and meta-analysis were performed on 10 available clinical studies (2 randomized controlled trials and 8 comparative studies). Subgroup analysis was performed by type of methodological quality. Partial weight bearing time in AP group was earlier than that in IF group (SMD = −0.86; 95% CI = −0.42, 1.29; P = 0.050). The overall outcomes such as mortality, reoperation rate, and complication showed no significant diffrence between the 2 groups (AP vs. IF). Therefore, this systematic review demonstrates that AP provides superior functional outcomes especially earlier mobilization, as compared to IF in elderly patients with an unstable intertrochanteric femoral fracture.

No MeSH data available.


Related in: MedlinePlus