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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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2025-04-01
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| author | I Gusti Agung Ditya Damara Nyoman Satria Nakayoshi Wijaya I Wayan Suryanto Dusak |
| author_facet | I Gusti Agung Ditya Damara Nyoman Satria Nakayoshi Wijaya I Wayan Suryanto Dusak |
| author_sort | I Gusti Agung Ditya Damara |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-ebdfde6170e24ebaa3df362b5773883c |
| institution | OA Journals |
| issn | 1028-4427 2542-131X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj-art-ebdfde6170e24ebaa3df362b5773883c2025-08-20T02:24:54ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2025-04-0131225226210.18019/1028-4427-2025-31-2-252-262Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysisI Gusti Agung Ditya Damara0https://orcid.org/0009-0002-4871-6780Nyoman Satria Nakayoshi Wijaya1https://orcid.org/0009-0006-0941-253XI Wayan Suryanto Dusak2Faculty of Medicine, Hang Tuah University, Surabaya, East Java, IndonesiaFaculty of Medicine, Udayana University, Denpasar, Bali, IndonesiaFaculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, IndonesiaIntroduction 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.proximal femoral nail antirotationbipolar hemiarthroplastyintertrochanteric fractureelderlyharris hip scorecomplications |
| spellingShingle | I Gusti Agung Ditya Damara Nyoman Satria Nakayoshi Wijaya I Wayan Suryanto Dusak Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis Гений oртопедии proximal femoral nail antirotation bipolar hemiarthroplasty intertrochanteric fracture elderly harris hip score complications |
| title | Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis |
| title_full | Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis |
| title_fullStr | Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis |
| title_full_unstemmed | Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis |
| title_short | Proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures: a meta-analysis |
| title_sort | proximal femoral nail antirotation versus bipolar hemiarthroplasty for intertrochanteric fractures a meta analysis |
| topic | proximal femoral nail antirotation bipolar hemiarthroplasty intertrochanteric fracture elderly harris hip score complications |
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