Safety and efficacy of surgical hip dislocation in managing femoral head fractures: A systematic review and meta-analysis  

作　　者：Ahmed A Khalifa Mohamed A Haridy Ali Fergany 

机构地区：[1]Department of Orthopaedic,Qena Faculty of Medicine and University Hospital,South Valley University,Qena 83523,Qina,Egypt [2]Department of Orthopaedic,Ibri Regional Hospital,Ibri 511,Oman [3]Department of Orthopaedic,Assiut University Hospital,Assiut 71515,Egypt

出　　处：《World Journal of Orthopedics》2021年第8期604-619,共16页世界骨科杂志（英文版）

摘　　要：BACKGROUND Femoral head fractures(FHFs)are considered relatively uncommon injuries;however,open reduction and internal fixation is preferred for most displaced fractures.Several surgical approaches had been utilized with controversial results;surgical hip dislocation(SHD)is among these approaches,with the reputation of being demanding and leading to higher complication rates.AIM To determine the efficacy and safety of SHD in managing FHFs by reviewing the results reported in the literature.METHODS Major databases including PubMed,Embase,Web of Science,and Cochrane Central Register of Controlled Trials were searched to identify studies reporting on outcomes of SHD utilized as an approach in treating FHFs.We extracted basic studies data,surgery-related data,functional outcomes,radiological outcomes,and postoperative complications.We calculated the mean differences for continuous data with 95%confidence intervals for each outcome and the odds ratio with 95%confidence intervals for binary outcomes.P<0.05 was considered significant.RESULTS Our search retrieved nine studies meeting our inclusion criteria,with a total of 129 FHFs.The results of our analysis revealed that the average operation time was 123.74 min,while the average blood loss was 491.89 mL.After an average followup of 38.4 mo,a satisfactory clinical outcome was achieved in 85%of patients,ranged from 30%to 86%,with avascular necrosis,heterotopic ossification,and osteoarthritis being the most common complications occurring at an incidence of 12%,25%,and 16%,respectively.Trochanteric flip osteotomy nonunion and trochanteric bursitis as a unique complication of SHD occurred at an incidence of 3.4%and 3.8%,respectively.CONCLUSION The integration of SHD approach for dealing with FHFs offered acceptable functional and radiological outcomes with a wide range of safety in regards to the hip joint vascularity and the development of avascular necrosis,the formation of heterotopic ossification,and the development of posttraumatic osteoarthritis;however,it still carri

关 键 词：Femoral head Pipkin fracture Surgical hip dislocation Ganz Systematic review META-ANALYSIS 

分 类 号：R687.3[医药卫生—骨科学]