Journal of orthopaedic surgery and research · 2026
Parallel versus non-parallel cannulated screw fixation for femoral neck fractures: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Jia Mingwang, Ding Chenning, Han Xing, Zhang Jiahui, Zhao Xin, Wang Zhiyong, Sang Xiguang
Аннотация
OBJECTIVE: Femoral neck fracture (FNF) is a common type of hip fracture, for which cannulated screw fixation is a primary internal fixation method. The optimal configuration for cannulated screw fixation remains controversial, with debate primarily focused on two approaches: parallel fixation configuration (PFC) versus non-parallel fixation configuration (NFC). The objective of this study was to compare the efficacy and safety of two configurations in the treatment of femoral neck fractures.
METHODS: Following PRISMA guidelines, we systematically searched PubMed, Embase, the Cochrane Library, and CNKI for studies comparing PFC and NFC in FNF fixation. Study quality was assessed using the Cochrane risk-of-bias tool and MINORS scale. Outcomes included femoral head necrosis, nonunion, femoral neck shortening, and fixation failure. Meta-analysis was conducted in RevMan 5.3, employing a fixed-effects model unless heterogeneity (I² > 50%) warranted an alternative approach.
RESULTS: A total of 20 studies involving 1,508 patients were included in the meta-analysis. The meta-analysis showed that the NFC group had significantly better outcomes, including lower rates of femoral head necrosis (OR 0.50, 95% CI 0.34-0.74, P = 0.0005), nonunion (OR 0.41, 95% CI 0.26-0.65, P = 0.0001), femoral neck shortening (OR 0.40, 95% CI 0.28-0.57, P < 0.00001), and internal fixation failure (OR 0.34, 95% CI 0.22-0.52, P < 0.00001).
CONCLUSIONS: Our findings indicate that NFC is more effective than traditional PFC for internal fixation of FNFs. Level of evidence Level III.
METHODS: Following PRISMA guidelines, we systematically searched PubMed, Embase, the Cochrane Library, and CNKI for studies comparing PFC and NFC in FNF fixation. Study quality was assessed using the Cochrane risk-of-bias tool and MINORS scale. Outcomes included femoral head necrosis, nonunion, femoral neck shortening, and fixation failure. Meta-analysis was conducted in RevMan 5.3, employing a fixed-effects model unless heterogeneity (I² > 50%) warranted an alternative approach.
RESULTS: A total of 20 studies involving 1,508 patients were included in the meta-analysis. The meta-analysis showed that the NFC group had significantly better outcomes, including lower rates of femoral head necrosis (OR 0.50, 95% CI 0.34-0.74, P = 0.0005), nonunion (OR 0.41, 95% CI 0.26-0.65, P = 0.0001), femoral neck shortening (OR 0.40, 95% CI 0.28-0.57, P < 0.00001), and internal fixation failure (OR 0.34, 95% CI 0.22-0.52, P < 0.00001).
CONCLUSIONS: Our findings indicate that NFC is more effective than traditional PFC for internal fixation of FNFs. Level of evidence Level III.