Association between Immediate Postoperative Radiographic Findings and Failed Internal Fixation for Trochanteric Fractures: Systematic Review and Meta-Analysis

Norio Yamamoto, Yasushi Tsujimoto, Suguru Yokoo, Koji Demiya, Madoka Inoue, Tomoyuki Noda, Toshihumi Ozaki, Takashi Yorifuji

Research output: Contribution to journalReview articlepeer-review

Abstract

Failed internal fixations for trochanteric fractures have a strong negative impact owing to increased postoperative mortality and high medical costs. However, evidence on the prognostic value of postoperative radiographic findings for failed internal fixations is limited. We aimed to clarify the association between comprehensive immediate postoperative radiographic findings and failed internal fixation using relative and absolute risk measures. We followed the meta-analysis of observational studies in epidemiology guidelines and the Cochrane handbook. We searched specific databases in November 2021. The outcomes of interest were failed internal fixation and cut-out. We pooled the odds ratios and 95% confidence intervals using a random-effects model and calculated the number needed to harm for each outcome. Thirty-six studies involving 8938 patients were included. The certainty of evidence in the association between postoperative radiographic findings and failed internal fixation or cut-out was mainly low or very low except for the association between intramedullary malreduction on the anteromedial cortex and failed internal fixation. Moderate certainty of evidence supported that intramedullary malreduction on the anteromedial cortex was associated with failed internal fixation. Most postoperative radiographic findings on immediate postoperative radiographs for trochanteric fractures were uncertain as prognostic factors for failed internal fixations.

Original languageEnglish
Article number4879
JournalJournal of Clinical Medicine
Volume11
Issue number16
DOIs
Publication statusPublished - Aug 2022

Keywords

  • cut-out
  • fixation failure
  • intertrochanteric fracture
  • mechanical failure
  • meta-analysis
  • pertrochanteric fracture
  • reduction
  • systematic review
  • tip–apex distance
  • trochanteric fracture

ASJC Scopus subject areas

  • Medicine(all)

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