Comparative efficacy of femoral neck system vs. cannulated compression screws in young patients with femoral neck fractures: a systematic review and meta-analysis
Notice bibliographique
Résumé
Background The optimal method for internal fixation of femoral neck fractures in younger individuals remains a subject of debate. This meta-analysis systematically evaluates and compares the clinical outcomes of the femoral neck system (FNS) and cannulated compression screws (CCSs) within this demographic. Methods A comprehensive literature search was conducted across the Cochrane Library, PubMed, Web of Science, and Embase databases, covering studies from their inception through March 2024. The search targeted cohort studies that compared FNS ( n = 265) and CCSs ( n = 326) in patients aged 14–65 years with femoral neck fractures. The methodological quality of the studies was appraised using the Newcastle–Ottawa Scale. Statistical analyses were executed using RevMan 5.4, with results presented as standardized mean differences (SMDs) or weighted mean differences (WMDs), accompanied by 95% confidence intervals (CIs). Results The analysis incorporated nine high-quality cohort studies involving 591 patients who underwent surgical procedures for femoral neck fractures. Of these patients, 265 were treated with the femoral neck system (FNS), while 326 were treated with CCSs. Meta-analysis revealed that, compared to CCS, FNS was associated with a significantly shorted fracture healing time (SMD = 16.30, 95% CI: 3.79–28.82, P < 0.001), decreased intraoperative fluoroscopy usage (WMD) = −8.14, 95% CI: −9.82 to −6.46, P < 0.001), and higher Harris hip scores at the final follow-up (WMD = −3.43, 95% CI: −4.08 to −2.77, P < 0.001). In addition, the FNS group exhibited a lower incidence of postoperative complications, including urinary tract infections, venous thromboembolism, non-union, screw loosening, and femoral head necrosis [risk ratio (RR) = 1.05, 95% CI: 0.92–1.19, P = 0.50]. However, the FNS was associated with a longer surgical incision (WMD = 0.84, 95% CI: 0.55–1.13, P < 0.001) and increased intraoperative blood loss (WMD = 16.30, 95% CI: 3.79–28.82, P = 0.01). The analysis revealed no statistically significant differences between the two techniques in terms of operation duration (WMD = −4.88, 95% CI: −12.25 to 2.48, P = 0.19), length of hospital stay (WMD = 0.10, 95% CI: −0.20 to 0.40, P = 0.52), or the excellent-to-good rate at the final follow-up (RR = 1.05, 95% CI: 0.92–1.19, P = 0.50). Conclusions The femoral neck system (FNS) may present potential benefits in specific outcomes, notably expedited healing and enhanced functional rehabilitation. The results of this study advocate for the consideration of the FNS as a preferred treatment option for active patients, where minimizing radiation exposure and optimizing long-term outcomes are prioritized, despite its slightly greater invasiveness.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,028 | 0,002 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».