Article

The use of a percutaneous compression plate (PCCP) provides a
minimally invasive technique for the fixation of stable intertrochanteric femoral
fractures. It has several theoretically potential advantages over the dynamic hip
screw (DHS) such as shorten incision and lower incidence of wound infection.
HYPOTHESIS : PCCP have several advantages than DHS, such as reduced blood loss,
transfusion, mortality, shorter operative time, and lower incidence of
complications. This systematic review and meta-analysis was performed to identify
the clinical outcomes and safety of patients with stable intertrochanteric hip
fractures operated on using PCCP compared with DHS. MATERIALS AND METHODS: A
systematic search of all studies published through April 2012 was conducted using
the Medline, Embase, Sciencedirect, OVID and the Cochrane Central database. The
randomized controlled trials (RCTs) and quasi-randomised control trials (qRCTs)
that compared PCCP with DHS in treating adult patients with stable
intertrochanteric hip fractures and provided data on safety and clinical effects
were identified. Demographic characteristics, adverse events and clinical
outcomes were manually extracted from all of the selected studies. RESULTS: Nine
studies encompassing 914 patients met the inclusion criteria. Overall, the result
of meta-analysis indicated that over DHS, PCCP allowed significantly shorter
operative time, reduced blood loss as well as transfusion, diminished incidence
of cardiovascular events. However, there were no significant differences in
length of hospitalization, rate of walking without help, early mortality and
other complications. DISCUSSION: Significant differences favoring PCCP were found
with regard to operative time, blood loss, transfusion and lower incidence of
cardiovascular events. However, owing to the limitations of this systematic
review, future RCTs are still needed to confirm this data and the clinical efficiency of PCCP. LEVEL OF EVIDENCE: Level II: low-powered prospective
randomized trial.
CI - Copyright (c) 2012. Published by Elsevier Masson SAS.

Langue : FRANCAIS