{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:52:39Z","timestamp":1791219159439,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2020,8]]},"abstract":"\n Objective<\/jats:title>\n \n To evaluate the clinical efficacy of internal fixation\n versus<\/jats:italic>\n hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A search was conducted in PubMed, Web of Science, Embase, and Cochrane Library databases up to April 2020. The present study compared internal fixation and hemiarthroplasty in the treatment of unstable intertrochanteric fractures in the elderly. RevMan5.3 software provided by the International Cochrane Group was used for the meta\u2010analysis. To compare the differences in the operation time, intraoperative bleeding, length of hospital stay, superficial infection, Harris hip score, mortality within 1\u2009year, mortality within 2\u2009years, reoperation, incidence of deep venous thrombosis (DVT), partial weight\u2010bearing time, non\u2010union, and implant\u2010related complications between an internal fixation group and an hemiarthroplasty group.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1300 patients were included in nine studies. The results showed that the operation time (\n MD<\/jats:italic>\n = \u221218.09, 95%\n CI<\/jats:italic>\n : \u221227.85\u2013\u22128.34,\n P<\/jats:italic>\n = 0.0003), intraoperative bleeding (\n MD<\/jats:italic>\n = \u2212195.31, 95%\n CI<\/jats:italic>\n : \u2212244.8\u2013\u2212147.74,\n P<\/jats:italic>\n \u2009<\u20090.0001), implant\u2010related complications (\n MD<\/jats:italic>\n = 3.83, 95%\n CI<\/jats:italic>\n : 1.74\u20138.45,\n P<\/jats:italic>\n = 0.0008), and partial weight\u2010bearing time (\n MD<\/jats:italic>\n = 17.21, 95%\n CI<\/jats:italic>\n : 1.63\u201332.79,\n P<\/jats:italic>\n = 0.03) have statistical significance. However, there is not statistical significance for the Harris hip joint function scale (HHS) (\n MD<\/jats:italic>\n = 5.60, 95%\n CI<\/jats:italic>\n : \u22121.13\u201312.33,\n P<\/jats:italic>\n = 0.10), DVT (\n MD<\/jats:italic>\n = 1.02, 95%\n CI<\/jats:italic>\n : 0.45\u20132.27,\n P<\/jats:italic>\n = 0.97), length of hospital stay (\n MD<\/jats:italic>\n = \u20101.08, 95%\n CI<\/jats:italic>\n : \u22122.82\u20130.66,\n P<\/jats:italic>\n = 0.22), superficial Infection (\n OR<\/jats:italic>\n = 0.92, 95%\n CI<\/jats:italic>\n : 0.43\u20131.98,\n P<\/jats:italic>\n = 0.89), mortality within 1 year (\n OR<\/jats:italic>\n = 0.95, 95%\n CI<\/jats:italic>\n : 0.61\u20131.48,\n P<\/jats:italic>\n = 0.81), mortality within 2\u2009years (\n OR<\/jats:italic>\n = 0.93, 95%\n CI<\/jats:italic>\n : 0.61\u20131.43,\n P<\/jats:italic>\n = 0.75), reoperation (\n MD<\/jats:italic>\n = 1.80, 95%\n CI<\/jats:italic>\n : 0.64\u20135.04,\n P<\/jats:italic>\n = 0.26), and non\u2010union (\n OR<\/jats:italic>\n = 1.20, 95%\n CI<\/jats:italic>\n : 0.48\u20133.03,\n P<\/jats:italic>\n = 0.70). The result of the subgroup analysis showed no significant differences between the less than 2\u2009years follow\u2010up and the 2\u2009years or more follow\u2010up group. The only difference was for the Harris hip score: the internal fixation group was superior to the hemiarthroplasty group in the less than 2\u2009years subgroup analysis, while there was no difference between the internal fixation group hemiarthroplasty group in the 2\u2009years or more subgroup analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared with the internal fixation group, those in the hemiarthroplasty group could carry out weight\u2010bearing training early and implant\u2010related complications were reduced, but it requires longer operation time and there is greater intraoperative blood loss. There is no difference in mortality, the incidence of DVT, non\u2010union, HHS, reoperation, length of hospital stay, and superficial infection. Hemiarthroplasty may be a better choice for unstable intertrochanteric fractures in the elderly.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.12736","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T03:31:25Z","timestamp":1595302285000},"page":"1053-1064","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Internal Fixation\n versus<\/i>\n Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fractures in the Elderly: A Systematic Review and\n Meta\u2010Analysis<\/scp>"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2626-8833","authenticated-orcid":false,"given":"Dong\u2010peng","family":"Tu","sequence":"first","affiliation":[{"name":"Zhejiang Chinese Medical University Second Clinical Medical College of Zhejiang Chinese Medical University Zhejiang China"},{"name":"Department of Orthopaedics Xinhua Hospital of Zhejiang Province, The Second Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8176-2482","authenticated-orcid":false,"given":"Zheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University Second Clinical Medical College of Zhejiang Chinese Medical University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7639-9984","authenticated-orcid":false,"given":"Yi\u2010kang","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University Second Clinical Medical College of Zhejiang Chinese Medical University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang Chinese Medical University Second Clinical Medical College of Zhejiang Chinese Medical University Zhejiang China"},{"name":"Department of Orthopaedics Xinhua Hospital of Zhejiang Province, The Second Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010lin","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xinhua Hospital of Zhejiang Province, The Second Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 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