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Arthroplasty or internal fixation for displaced femoral neck fractures: which is the optimal alternative for elderly patients? A meta-analysis

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Abstract

We conducted an up-to-date meta-analysis of 20 eligible randomised controlled trials (RCTs) containing 3,109 patients to compare arthroplasty with internal fixation of displaced femoral neck fractures regarding the effect on clinical outcomes. Computerised databases were searched for RCTs published from January 1979 to May 2008. The results showed that compared to internal fixation arthroplasty led to significantly fewer surgical complications at two and five years postoperatively and reduced the incidence of reoperation at one, two and five years postoperatively (P < 0.001). However, arthroplasty was associated with greater risk of deep wound infection, longer operating time and greater operative blood loss. Arthroplasty substantially increased the risk of reoperation following deep wound infection (P < 0.05). For mortality, there was increased postoperative risk for arthroplasty compared with internal fixation, but there was no statistically significant difference between the two groups at the different follow-up times. For pain at one year postoperatively, the result showed no statistically significant difference.

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Acknowledgments

This work was supported by the Key Projects in the National Science & Technology Pillar Program in the Eleventh Five-year Plan Period in the People’s Republic of China (Grant No.: 2007BAI04B00). We would like to thank the authors who provided additional data and the staff for help with the literature search in Peking University Health Science Library, and we thank Feng Wang, Ph.D. for his support.

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Authors and Affiliations

  1. Department of Orthopedics and Trauma, Peking University People’s Hospital, South Xi-Zhi-Men Street 11, Beijing, People’s Republic of China, 100044

    Jing Wang, Baoguo Jiang & Peixun Zhang

  2. School of Population Health, University of Auckland, Auckland, New Zealand

    Roger J. Marshall

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  1. Jing Wang
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  2. Baoguo Jiang
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  3. Roger J. Marshall
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  4. Peixun Zhang
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Correspondence to Baoguo Jiang.

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Wang, J., Jiang, B., Marshall, R.J. et al. Arthroplasty or internal fixation for displaced femoral neck fractures: which is the optimal alternative for elderly patients? A meta-analysis. International Orthopaedics (SICOT) 33, 1179–1187 (2009). https://doi.org/10.1007/s00264-009-0763-8

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