Complications après fixation par vis canulées parallèles et non parallèles des fractures du col fémoral : revue systématique et méta-analyse - 17/08/21

Parallel and non-parallel cannulated screw fixation complications in femoral neck fractures: A systematic review and meta-analysis

Doi : 10.1016/j.rcot.2021.06.044

Eic Ju Lim ^a, Beom-Su Kim ^b, Chul-Ho Kim ^c,^⁎
^a Department of Orthopaedic Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Chungbuk National University, Cheongju, République de Corée
^b Department of Orthopaedic Surgery, Gachon University Gil Medical Center, Incheon, République de Corée
^c Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-ku, Seoul, 06973 République de Corée

^⁎Auteur correspondant.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 17 August 2021
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Abstract

Background

Since its introduction in the early 1960s, the multiple cannulated screw fixation method has been developed for use in femoral neck fractures (FNFs); however, the parallelism of screws remains controversial.

Materials and Methods

MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published before June 2, 2020, that compared the use of parallel and non-parallel screw fixation for the treatment of FNF. The pooled analysis was designed to identify differences between the two groups and focused on postoperative complications, including fracture nonunion and osteonecrosis of the femoral head (ONFH).

Results

Over four studies, we enrolled 445 patients, including 195 patients with fixed FNF with parallel trajectory screws and 250 patients with fixed FNF with non-parallel screws. The pooled analysis showed no difference in the nonunion rates (odds ratio (OR)=0.91; 95 % confidence interval (CI), 0.24–3.44; P=0.89) and no significant difference in the incidence of ONFH between parallel and non-parallel screw fixation (OR=0.74; 95 % CI: 0.21–2.63; P=0.64).

Conclusions

The results of this meta-analysis reveal that screw parallelism in multiple cannulated screw fixation of FNF has no relationship with either the fracture nonunion rate or the incidence of postoperative ONFH.

Level of evidence

III; meta-analysis.

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Keywords : Multiple cannulated screw, Femoral neck fracture, Parallel, Non-parallel, Diverge, Cross, Meta-analysis

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.