Key result
Cannulated screw plus medial femoral plate improves fracture healing and reduces fixation failure versus simple screws.
Why the study?
The comparative efficacy and complications of cannulated screw combined with medial femoral plate versus simple cannulated screw for Pauwels type III femoral neck fracture were unclear.
Does cannulated screw combined with medial femoral plate improve therapeutic efficacy and reduce complications compared to simple cannulated screw in patients with Pauwels type III femoral neck fracture?
Meta-Analysis
Does cannulated screw combined with medial femoral plate improve therapeutic efficacy and reduce complications compared to simple cannulated screw in patients with Pauwels type III femoral neck fracture?
p-value: p=<0.05
Cannulated screw combined with medial femoral plate provides better fracture reduction and healing outcomes with fewer fixation failures than simple cannulated screws for Pauwels type III femoral neck fractures, despite increased surgical time and blood loss.
May support combined fixation for better outcomes in Pauwels III fractures; leaves open need for randomized confirmation.
This study aimed to compare the efficacy of cannulated screw combined with medial femoral plate and simple cannulated screw for Pauwels type III femoral neck fracture. In May 2022, relavent clinical trial articles were searched in seven online databases. After literature screening, quality evaluation, and data extraction according to the specific inclusion and exclusion criteria, the differences in therapeutic efficacy, complications, and intraoperative outcomes were compared between the two groups. A total of nine articles were finally included in the meta-analysis. The qualities of the nine articles were medium. Although the results showed that cannulated screw combined with medial femoral plate prolonged the operation time and increased blood loss (p <0.05), it demonstrated better fracture reduction and Harris score, shorter healing time and less internal fixation failure than in the simple cannulated screw in the treatment of Pauwels type III fracture (p <0.05). The sensitivity analysis, Egger's test, and trial sequential analysis (TSA) showed that the combination results were stable and reliable. This demonstrated that compared to that with the simple cannulated screw, the cannulated screw combined with medial femoral plate had better efficacy and less complication.
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Li et al. (2023) conducted a meta-analysis in Pauwels type III femoral neck fracture. Cannulated screw combined with medial femoral plate vs. Simple cannulated screw was evaluated on Therapeutic efficacy, complications, and intraoperative outcomes (p=<0.05). Cannulated screw combined with medial femoral plate improved fracture reduction, Harris score, healing time, and internal fixation failure compared to simple cannulated screw (p <0.05).
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