Meta-analysis Of The Efficacy Of Cannulated Screw Internal Fixation Combined With Platelet-rich Plasma For The Treatment Of Femoral Neck Fracture

Objective:The meta-analysis system was used to evaluate the difference in efficacy between cannulated internal fixation combined with platelet rich plasma and simple cannulated internal fixation in the treatment of femoral neck fracture.Methods:Using the Cochrane Library,PubMed,Wanfang Medical Network,China Knowledge Network,and China Journal Full-text Database to search and collect clinical controlled trials of cannulated screw internal fixation combined with platelet-rich plasma and cannulated screw internal fixation for the treatment of femoral neck fractures published from January 2010 to January 2019.Screen the searched documents according to the established inclusion and exclusion criteria and determine the included documents,two reviewers independently evaluated the quality of the included studies,extracted data and checked each other,and meta-analyzed the collected data with RevMan 5.3 software.Results:A total of 7 clinical randomized controlled trials were selected for meta-analysis.The data analysis showed that the two treatments were Harris scores at 1 、3、6、9、12month Harris score [MD=1.34,95%CI(1.08,1.61),P<0.00001]、[MD=3.33,95%CI(2.96,3.70),P<0.00001]、[MD=2.32,95%CI(2.06,2.59),P<0.00001]、[MD=1.36,95%CI(1.10,1.62),P<0.00001]、[MD=1.71,95%CI(1.53,1.90),P<0.00001],fracture healing time [MD=-1.86,95% CI(-2.97,-0.75)),P=0.0001],healing rate [OR=6.51,95% CI(3.36,12.62),P<0.00001],necrosis rate [OR=0.25,95% CI(0.15,0.44),P<0.00001] were statistically significant.The results of overall subgroup analysis of hip joint Harris score showed that the Harris score of hip joint after treatment of femoral neck fracture with cannular screw internal fixation combined with platelet-rich plasma was higher [MD = 1.84,95%ci(1.73,1.95),P < 0.00001] Conclusion:Cannulated screw internal fixation combined with platelet-rich plasma for femoral neck fracture is more effective than that of cannulated screw fixation alone.Combined treatment can accelerate the healing of patients,improve the healing rate,reduce the rate of necrosis,and promote the recovery of postoperative hip joint function.