Treatment comparison of femoral shaft with femoral neck fracture: A meta-analysis

Abstract

Background: To compare the efficacy and complications between reconstruction nail and hollow screw+plate in patients with femoral shaft and femoral neck fracture. Methods: The full text of studies on clinical efficacy involving reconstruction nail and hollow screw+plate was retrieved from multiple databases. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis. The meta-analysis was conducted with respect to the operation time, blood loss, healing time of the femoral shaft, healing time of the femoral neck, and complications. Finally, 10 studies met the eligibility criteria, including 991 patients. Results: The meta-analysis suggested better characteristics for the reconstruction nail compared with the hollow screw+plate regarding operation time (OR = - 82.41, 95% CI [- 91.72, - 73.10], P < 0.00001; P for heterogeneity < 0.00001, I 2 = 98%), blood loss (OR = - 388.01, 95% CI [- 422.95, - 353.06], P < 0.00001; P for heterogeneity < 0.00001, I 2 = 99%), healing time of femoral shaft (MD = - 3.89, 95% CI [- 4.74, - 3.05], P < 0.00001; P for heterogeneity < 0.00001, I 2 = 99%), healing time of femoral neck (MD = - 4.04, 95% CI [- 4.33, - 3.75], P < 0.00001; P for heterogeneity = 0.008, I 2 = 60%), and complications (OR = 0.47, 95% CI [0.31, 0.73], P = 0.0006; P for heterogeneity = 1.00, I 2 = 0%). Conclusion: This meta-analysis shows that a reconstruction nail is a more efficient and safer treatment than a hollow screw+plate for patients with femoral shaft and femoral neck fracture.