Surgical approaches and ancillary techniques for internal fixation of intracapsular proximal femoral fractures

摘要: BACKGROUND In the fixation of intracapsular hip fractures, different implants, surgical approaches and ancillary manoeuvres have been employed to improve reduction, stability reconstruction, in an attempt reduce frequency non-union aseptic necrosis femoral head. OBJECTIVES To compare alternative techniques internal fractures which subjected randomised quasi-randomised trials adults. SEARCH STRATEGY The Cochrane Musculoskeletal Injuries Group Specialised Register, MEDLINE, reference lists relevant articles were searched. Date most recent search: November 2004. SELECTION CRITERIA All investigating operative technique for treatment fractures. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality, by use a 10 item checklist, extracted data. MAIN RESULTS One with 103 participants studied effect impaction fracture at time surgery. only outcome measure reported was bone scintimetry. There some evidence that impaction, particularly displaced resulted reduction blood flow head as 220 compared compression no compression. Results 156 individuals one year showed tendency lower incidence those treated without compression.Two trials, involving 102 young adults under 50 years old other 49 older people aged 65 or over, open versus closed fracture. Both found significantly increased length None differences between outcomes two statistically significant. AUTHORS' CONCLUSIONS Insufficient exists from confirm relative effects intra-operative fixation.