Minimally invasive versus conventional dynamic hip screw for the treatment of intertrochanteric fractures in older patients.

Abstract

The purpose of this study was to compare minimally invasive and conventional dynamic hip screw techniques for the treatment of intertrochanteric fractures in older patients. Relevant randomized, controlled studies were included. The methodological quality was assessed, and data were extracted independently. Five studies (353 fractures) that compared minimally invasive and conventional dynamic hip screw techniques were included. The rates of serious postoperative complications, operative time (minutes), hemoglobin decrease (g/dL), postoperative Harris Hip Scores, and length of stay (days) were the outcomes of interest. A lower rate of serious postoperative complications was correlated with the minimally invasive dynamic hip screw group compared with the conventional dynamic hip screw group (relative risk, 0.35; 95% confidence interval [CI], 0.16, 0.78), average operative time (weighted mean difference, -16.32; 95% CI, -28.78 to -3.86), hemoglobin decrease (weighted mean difference, -1.44; 95% CI, -1.98 to -0.89), and length of stay (weighted mean difference, -3.72; 95% CI, -5.44 to -2.01) were lower in the minimally invasive dynamic hip screw group, and the postoperative Harris Hip Score (weighted mean difference, 1.42; 95% CI, 0.23 to 2.60) was higher in the minimally invasive dynamic hip screw group.