| Objective To compare the fixation efficacy difference between Intertan nail and proximal femoral nail antiradiation(PFNA) in treating those elderly patients with femoral intertrochanteric fractures,and to evaluate their advantages and disadvantages by meta-analysis.Methods The related literatures of randomized controlled trials or retrospective cohort studies comparing Intertan nail and PFNAin treatment of elderly patients with femoral intertro chanteric fractures,published between Oct 2014 and Jun 2017 and indexed by such foreign databases as PubMed,Medline,Cochrane Library and such Chinese databases as Wanfang, CNKI, VIPand so on, were searched. Literature screening, data extraction and quality evaluation were separately performed by two reviewers, and such indexes asduration of surgery,intraope rative blood loss, excellent rate of Harris joint function score, postoperativetip-cortex distance(TAD), Harris hip score,time to bonyunion, postoperative complications, rate of incision infection, rate of inner fixation failure and rate of fracture nonunion, were compared between the patients receiving Intertan nailand PFNA. The software RevMan5.3 was used for further meta-analysis.Results A total of 918 patients from ten pieces of selected articles were included in this meta-analysis (472 patients of the Intertan nail group and 446 patients of the PFNAgroup).Although duration of surgery and blood loss in the PFNA group were both significantly less than thosein the Intertan nail group (P<0.05), but there was no significant difference in the time to bony union,post operative Harris hip score and TAD, rate of incision infection and rate of fracture nonunion between the PFNA andIntertan nail groups(P>0.05).The Intertan nail group had lower rates of post operative complications and inner fixation failure than those in the PFNA group, with significant differences between them (P<0.05).Conclusion Both of Intertan nailand PFNA system could beused as areasonable choice for the treatment of femoral intertrochanteric fractures in elderly patients. Patients with poor physical condition sand tolerance for long operation time are well suited for PFNA fixation;otherwise Intertan nail system may be apreferable choice. |
