They are widely classified into stable and unstable fractures based on the fracture pattern. Per-trochanteric fractures occur in the area of the proximal femur between the intertrochanteric line and an imaginary horizontal line passing through the lower margin of the lesser trochanter. Fifty per cent of all hip fractures are per-trochanteric, of which up to 40% are considered unstable. Hip fractures are one of the most common injuries affecting the elderly population and are associated with significant morbidity and mortality. Conclusionīoth CMN and DHS w/TSP proved to be reliable in the management of unstable per-trochanteric fractures however, more extensive datasets are required to draw robust conclusions. The results of this analysis suggest that CMN is only associated with lower revision rates when compared to DHS w/ TSP however, no significant difference was found in terms of hospital stay, operative time, blood transfusion, complications rate and functional outcome. ResultsĪ total of five studies were included in the meta-analysis. Hospital stay, operative time, intra-operative complication rate, mechanical failure rate, infection rates, revision rates and functional outcomes were all considered. ![]() All suitable literature was appraised for methodological quality using the Cochrane’s collaboration tool. MethodsĪn up-to-date literature search was performed using a predetermined search strategy and eligibility criteria. This meta-analysis is the first to determine the efficacy of CMN versus DHS w/ TSP. Management of these kinds of injuries is very challenging in orthopaedic practice, yet no strong evidence is in place to delineate which implant gives the best results. However, a robust meta-analysis does not exist in the current literature comparing the two fixation methods. A growing body of literature has reported good functional and radiological outcomes in patients managed with a dynamic hip screw supplemented with a trochanteric stabilisation plate (DHS w/ TSP). The use of cephalo-medullary nails (CMN) is a widely accepted management option for the treatment of unstable per-trochanteric hip fractures.
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