Long‐Term Efficacy of Screw Fixation <i>vs</i> Hemiarthroplasty for Undisplaced Femoral Neck Fracture in Patients over 65 Years of Age: A Systematic Review and Meta‐Analysis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Objective To compare the long‐term efficacy of screw fixation and hemiarthroplasty in elderly patients with undisplaced femoral neck fractures. Methods We searched Cochrane Library, EMBASE, and MEDLINE from inception to 10 June 2020 to identify studies about undisplaced femoral neck fracture in elderly patients over 65 years of age. The included studies were assessed by two researchers according to the Cochrane risk‐of‐bias criteria and Newcastle–Ottawa Scale. Meta‐analysis was performed with Revman 5.3 software. The odds ratios (OR) and mean differences (MD) were used to compare dichotomous and continuous variables. Results A total of 750 patients were included in this meta‐analysis. In elderly patients, undisplaced femoral neck fracture treated with hemiarthroplasty had a lower implant‐related complication rate ( OR , 4.05 [95% CI , 2.38 to 6.89]; P < 0.00001; I 2 = 0), lower reoperation rate ( OR , 4.88 [95% CI , 2.84 to 8.38]; P < 0.00001; I 2 = 0), and superior Harris score ( WMD , −5.05 [95% CI , −7.30 to −2.80]; P < 0.0001; I 2 = 0) in the early postoperative period. Although screw fixation was associated with shorter operative time ( WMD , −36.22 [95% CI , −50.72 to −21.73]; P < 0.00001; I 2 = 98%) and less blood loss ( WMD , −165.84 [95% CI , −209.29 to −122.38]; P < 0.00001; I 2 = 96%), there was no significant difference in long‐term mortality ( OR , 0.65 [95% CI , 0.28 to 1.48]; P < 0.31; I 2 = 75%) between these two treatments. Conclusion In elderly patients with undisplaced femoral neck fractures, hemiarthroplasty provided a lower implant‐related complication rate, lower reoperation rate, superior hip function without increased long‐term mortality. Hemiarthroplasty should be recommended as a better alternative in such patients compared with multiple cannulated screws.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it