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Parallel and non-parallel cannulated screw fixation complications in femoral neck fractures: A systematic review and meta-analysis [Complications après fixation par vis canulées parallèles et non parallèles des fractures du col fémoral : revue systématique et méta-analyse]

Authors
Lim, E.J.Kim, B.-S.Kim, C.-H.
Issue Date
2021
Publisher
Elsevier Masson s.r.l.
Keywords
Cross; Diverge; Femoral neck fracture; Meta-analysis; Multiple cannulated screw; Non-parallel; Parallel
Citation
Revue de Chirurgie Orthopedique et Traumatologique, v.107, no.6, pp 806
Journal Title
Revue de Chirurgie Orthopedique et Traumatologique
Volume
107
Number
6
Start Page
806
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/62876
DOI
10.1016/j.rcot.2021.06.044
ISSN
1877-0517
Abstract
Background: Since its introduction in the early 1960s, the multiple cannulated screw fixation method has been developed for use in femoral neck fractures (FNFs); however, the parallelism of screws remains controversial. Materials and Methods: MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published before June 2, 2020, that compared the use of parallel and non-parallel screw fixation for the treatment of FNF. The pooled analysis was designed to identify differences between the two groups and focused on postoperative complications, including fracture nonunion and osteonecrosis of the femoral head (ONFH). Results: Over four studies, we enrolled 445 patients, including 195 patients with fixed FNF with parallel trajectory screws and 250 patients with fixed FNF with non-parallel screws. The pooled analysis showed no difference in the nonunion rates (odds ratio (OR) = 0.91; 95 % confidence interval (CI), 0.24–3.44; P = 0.89) and no significant difference in the incidence of ONFH between parallel and non-parallel screw fixation (OR = 0.74; 95 % CI: 0.21–2.63; P = 0.64). Conclusions: The results of this meta-analysis reveal that screw parallelism in multiple cannulated screw fixation of FNF has no relationship with either the fracture nonunion rate or the incidence of postoperative ONFH. Level of evidence: III; meta-analysis. © 2021 Elsevier Masson SAS
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