Comparative outcomes of internal fixation versus prosthetic reconstruction in the treatment of proximal femoral metastases: 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
Background: Metastatic disease frequently causes pathological fractures, particularly in the proximal femur, significantly impacting patient prognosis and quality of life. With the advancements in cancer treatment leading to longer survival, there is a pressing need to evaluate the outcomes of surgical interventions aimed at managing proximal femoral metastases. This study compares the outcomes of internal fixation (IF) versus prosthesis (P) in the treatment of proximal femoral metastases, focusing on survival times, complication rates, functional outcomes, and reoperation rates. Method: A systematic review and meta-analysis were conducted, searching PubMed, Embase, and Cochrane databases for studies published up to December 31, 2023. The PRISMA guidelines were followed. Studies comparing IF and P for proximal femoral metastases were included. Data on survival times, blood loss, reoperation rates, and functional scores were extracted and analyzed using the forest plot technique and inverse variance method. The quality of included studies was assessed using the Newcastle-Ottawa scale. Results: In total, 19 studies (16 retrospective and three prospective) involving 4,126 patients were included. The P group demonstrated significantly longer survival times compared with the IF group, with no significant difference in complication and reoperation rates between the two methods. However, IF was associated with shorter operative times and less blood loss. Conclusion: P may provide superior long-term functional outcomes and extended survival compared with IF, with similar rates of complications and reoperations. However, selection bias - where healthier patients with better baseline physiology are more likely to undergo prosthetic reconstruction - significantly impacts the interpretation of these findings, underscoring the need for further prospective studies.
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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 | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.020 | 0.003 |
| Bibliometrics | 0.000 | 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