|
Objective: systematic evaluation of total hip replacement with open reduction and internal fixation of femoral neck fracture efficacy. Compare their efficacy differences in order to better guide the the clinical surgical options. METHODS: the computer retrieval MEDLINE (1995 to 12), Chinese Biomedical Literature Database (January 1995-December 2009), CHKD, VIP database, PubMed, Ovid database to collect all relevant randomized controlled trials and retrospective studies, and to evaluate the methodological quality of the included studies. Development of literature inclusion and exclusion criteria, in strict accordance with the standard screening literature, and enrolled in the study quality assessment using the Jadad scale, and extract data from the application of statistical software provided by the Cochrane Collaboration RevMan 4.2.8 for analysis. Results: A total of six randomized controlled trials, a retrospective study. Six reports in the literature the case fatality rate of total hip replacement and reduction and internal fixation of femoral neck fracture after 12 to 24 months, a total of 532 cases, which it accepted 260 cases of total hip replacement, to accept reduction and internal fixation of 272 cases results, the efficacy of the two methods, the difference was not statistically significant (OR = 0.75, 95% CI [0.47, 1.19]). This suggests that mortality compared with open reduction and internal fixation, total hip arthroplasty does not l. Six reports in the literature of total hip replacement and reduction and internal fixation of femoral neck fracture surgery postoperative reoperation rate of 12 to 24 months, a total of 526 cases, which it accepted 252 cases of total hip replacement, the two methods Comparison of efficacy, the difference was statistically significant (OR = 0.19, 95% CI [0.10, 0.35]). This indicates that total hip replacement surgery, the incision reduction and internal fixation of postoperative reoperation rate increased. Four reports in the literature of total hip replacement and reduction and internal fixation of femoral neck fracture surgery hip pain incidence, a total of 446 cases, which it accepted 219 cases of total hip replacement, accept reduction and internal fixation of the 227 cases, both the efficacy of the method, the difference was not statistically significant (OR = 0.63, 95% CI [0.30, 1.35]). This indicates that compared with total hip arthroplasty, total hip arthroplasty incidence of pain was not up. Conclusion: Compared with open reduction and internal fixation compared with total hip arthroplasty can reduce the re-operation rate of the femoral neck fracture; total hip arthroplasty with open reduction and internal fixation of postoperative mortality and postoperative hip the incidence of pain, the difference was not statistically significant. Two surgical methods and pulmonary complications, fracture healing time, infection, operative time and blood loss and other indicators of relationships, and economic evaluation needs further study.
|