Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis
Introduction Intertrochanteric fractures account for almost half of all hip fractures, with a mortality rate of 15 to 20 % within one year following fracture, primarily in elderly patients aged 65 years old and older. The purpose of this study is to compare the operative time, intraoperative blood...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2025-04-01
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| Series: | Гений oртопедии |
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| Summary: | Introduction Intertrochanteric fractures account for almost half of all hip fractures, with a mortality rate
of 15 to 20 % within one year following fracture, primarily in elderly patients aged 65 years old and older.
The purpose of this study is to compare the operative time, intraoperative blood loss, intraoperative
blood transfusion, hospitalization time, weight-bearing time, Harris Hip Score at 1, 3, 6, 12 months
follow-up, and complications after proximal femoral nail antirotation versus bipolar hemiarthroplasty
for intertrochanteric fracture in elderly patients based on the published literature of their comparison.
Methods We conducted a comprehensive search in the electronic databases such as PubMed, Scopus,
and Google Scholar. Original articles up to November 2024 were screened, focusing on retrospective
or prospective cohort studies.
Results and Discussion The initial search yielded 702 studies. Six cohort studies with a total
of 495 participants were assessed. The Proximal Femoral Nail Antirotation (PFNA) showed statistically
significant shorter operative time (p = 0.006), lower intraoperative blood loss (p < 0.0001) compared
with bipolar hemiarthroplasty. Bipolar Hemiarthroplastty had statistically significant better Harris Hip
Score at 1 and 3 month follow-up post-operatively (p < 0.00001), (p = 0.001). It provides early weight-bearing
(p = 0.003) and helps mobilize post-operative patients. Blood transfusion, hospitalization time, Harris Hip
Score after 6- month follow-up, and complications had balanced results between two apporaches.
Conclusion PFNA and bipolar Hemiarthroplasty have comparable results in intertrochateric fractures
in the elderly. PFNA has the advantages of shorter operative time, and lower intraoperative blood loss. Bipolar
hemiarthroplasty has the advantages of better Harris Hip Score at 1 and 3 month follow-up and earlier
weight-bearing.
Level of Evidence: I. |
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| ISSN: | 1028-4427 2542-131X |