Meta-analysis Of Long And Short Intramedullary Nails For Unstable Intertrochanteric Fractures

Objective:To systematically evaluate the efficacy of long and short intramedullary nails in the treatment of unstable femoral intertrochanteric fractures.Method: PubMed,OVID,the Cochrane Library,Web of Science,CNKI and cqVip standards databases were searched,and relevant conference papers were obtained by manual retrieval.Control studies on the treatment of unstable intertrochanteric fractures with two kinds of intramedullary nails were selected.The long type intramedullary nail treatment group was "L group",and the short type intramedullary nail treatment group was "S group".Jadad Scale and the Newcastle Ottawa Scale(NOS)were used to evaluate the quality of the included literatures.Stata 12.0 statistical software was used for Meta analysis.Comparison indexes of the two groups included: operation time,intraoperative blood loss,intraoperative fluoroscopy time,hospitalization time,Harris hip scores(HHS)at the last follow-up visit,femoral shaft refracture rate,reoperation rate,complications(infection,screw/ blade cut out,poor healing),etc.Result: A total of 7 studies were included,of threewere randomized controlled study,four were retrospective cohort study,participants included 641 cases of patients,282 examples in L group,359 examples in S group,the results show that the operation time,intraoperative blood loss,intraoperative fluoroscopy time of group S was better than group L(P < 0.05),the last follow-up HHS,femoral fracture rate of group L is superior to the group S(P < 0.05),there was no significant difference in time perspective,reoperation rate,complications between two groups(P > 0.05).Conclusions: short intramedullary nailing for unstable intertrochanteric fractures has shorter operative time and less trauma,but the risk of femoral shaft refracture is higher than that of long intramedullary nailing.However,due to the limitations of the included studies,more large sample randomized controlled trials and longer follow-up visits are required for verification.