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• W4244421380 abstract "Background Intramedullary nails may be used for the surgical fixation of extracapsular hip fractures in adults. Objectives To compare different types or design modifications of intramedullary nails used in the fixation of extracapsular hip fractures. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (June 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 2), MEDLINE (1966 to June week 3 2007), EMBASE (1988 to 2007 Week 27), the UK National Research Register, Current Controlled Trials, orthopaedic journals, conference proceedings and reference lists of articles. Selection criteria All randomised or quasi‐randomised trials comparing different types of intramedullary nails or modifications to the design of intramedullary nails in the treatment of extracapsular hip fractures in adults. Data collection and analysis Both authors independently assessed trial quality and extracted data. Additional information was sought from all trialists. Main results Nine studies, involving a total of 1290 predominantly female and older people with mainly unstable trochanteric fractures, were included. Allocation concealment was confirmed in only one trial. Four studies (910 participants) compared the proximal femoral nail with the Gamma nail. There was no statistically significant difference between the two implants in operative fracture of the femur (1/455 versus 5/455; relative risk 0.33, 95% confidence interval 0.07 to 1.63) nor differences for fracture healing complications, reoperations, other post‐operative complications, mortality or function. Two studies (185 participants) found no notable differences between the ACE nail versus the Gamma nail. One study (34 participants, all under 50 years) found no difference between the Recon nail versus the long Gamma nail. One study (80 participants) found no differences between a gliding nail versus a standard Gamma nail. Another study (81 participants) found no difference between a dynamically versus a statically locked intramedullary hip screw. Authors' conclusions The limited evidence from the randomised trials undertaken to date is insufficient to determine whether there are important differences in outcome between different designs of intramedullary nails used in the internal fixation of extracapsular hip fractures. Given the evidence of superiority of the sliding hip screw compared with intramedullary nails for extracapsular hip fractures, further studies comparing different designs of intramedullary nails are not a priority. Any new design should be evaluated in a randomised comparison with the sliding hip screw." @default.
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• W4244421380 date "2006-07-19" @default.
• W4244421380 modified "2023-09-29" @default.
• W4244421380 title "Intramedullary nails for extracapsular hip fractures in adults" @default.
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• W4244421380 doi "https://doi.org/10.1002/14651858.cd004961.pub3" @default.
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