BACKGROUND The traditional Gamma3 nail is a mainstream treatment for femoral intertrochanteric fractures.Literature reports that the Gamma3U-blade system can increase the stability of the Gamma3 nail and reduce compli...BACKGROUND The traditional Gamma3 nail is a mainstream treatment for femoral intertrochanteric fractures.Literature reports that the Gamma3U-blade system can increase the stability of the Gamma3 nail and reduce complication incidence.However,comparative studies between the Gamma3U-blade and Gamma3 systems are limited;hence,this meta-analysis was performed to explore the clinical efficacy of these two surgical methods.AIM To investigate the clinical efficacy of Gamma3 and Gamma3 U-blade for intertrochanteric fractures.METHODS A computerized search for Chinese and English literature published from 2010 to 2022 was conducted in PubMed,Cochrane,CNKI,Wanfang,and VIP databases.The search keywords were gamma 3,gamma 3 U blade,and intertrochanteric fracture.Additionally,literature tracking was performed on the references of published literature.The data were analyzed using Revman 5.3 software.Two individuals checked the inputs for accuracy.Continuous variables were described using mean difference and standard deviation,and outcome effect sizes were expressed using ratio OR and 95%confidence interval(CI).High heterogeneity was considered at(P<0.05,I2>50%),moderate heterogeneity at I2 from 25%to 50%,and low heterogeneity at(P≥0.05,I2<50%).RESULTS Following a comprehensive literature search,review,and analysis,six articles were selected for inclusion in this study.This selection comprised five articles in English and one in Chinese,with publication years spanning from 2016 to 2022.The study with the largest sample size,conducted by Seungbae in 2021,included a total of 304 cases.Statistical analysis:A total of 1063 patients were included in this meta-analysis.The main outcome indicators were:Surgical time:The Gamma3U blade system had a longer surgical time compared to Gamma3 nails(P=0.006,I2=76%).Tip-apex distance:No statistical significance or heterogeneity was observed(P=0.65,I2=0%).Harris Hip score:No statistical significance was found,and low heterogeneity was detected(P=0.26,I2=22%).Union time:No statistical significance was found,and high heterogeneity was detected(P=0.05,I2=75%).CONCLUSION Our study indicated that the Gamma3 system reduces operative time compared to the Gamma3 U-blade system in treating intertrochanteric fractures.Both surgical methods proved to be safe and effective for this patient group.These findings may offer valuable insights and guidance for future surgical protocols in hip fracture patients.展开更多
目的：观察加长Gamma3髓内钉闭合复位在股骨粗隆下粉碎性骨折中的应用效果。方法选择我院2010年1月~2013年12月收治的80例股骨粗隆下粉碎性骨折患者为研究对象，均行闭合复位治疗，随机将其分为治疗组（n=46），行加长Gamma 3髓内钉治...目的：观察加长Gamma3髓内钉闭合复位在股骨粗隆下粉碎性骨折中的应用效果。方法选择我院2010年1月~2013年12月收治的80例股骨粗隆下粉碎性骨折患者为研究对象，均行闭合复位治疗，随机将其分为治疗组（n=46），行加长Gamma 3髓内钉治疗，对照组（n=34）行动力髋螺钉治疗，术后随访12个月，比较两组手术结果、骨折愈合时间、功能恢复及并发症等情况。结果两组手术时间[（57.34±11.52）min vs（67.25±18.38）min]、术中出血量[（145.78±28.57）mL vs （264.55±25.26）mL]、住院时间[（14.20±2.63）d vs （18.65±3.00）d]及骨折愈合时间[（10.38±2.46）周 vs（14.21±2.24）周]比较，差异有统计学意义（P＜0.05）。另外随访1年，两组功能恢复优良率（91.30% vs 82.35%）比较，差异无统计学意义（P＞0.05），但两组并发症发生率（2.17% vs 17.65%）比较，差异有统计学意义（P＜0.05）。结论股骨粗隆下粉碎性骨折应用加长Gamma 3髓内钉闭合复位治疗，功能恢复良好，并发症少，值得临床推广。展开更多
基金Supported by The Clinical Medical Science and Technology Development Fund Project of Jiangsu University,No.JLY2021185.
文摘BACKGROUND The traditional Gamma3 nail is a mainstream treatment for femoral intertrochanteric fractures.Literature reports that the Gamma3U-blade system can increase the stability of the Gamma3 nail and reduce complication incidence.However,comparative studies between the Gamma3U-blade and Gamma3 systems are limited;hence,this meta-analysis was performed to explore the clinical efficacy of these two surgical methods.AIM To investigate the clinical efficacy of Gamma3 and Gamma3 U-blade for intertrochanteric fractures.METHODS A computerized search for Chinese and English literature published from 2010 to 2022 was conducted in PubMed,Cochrane,CNKI,Wanfang,and VIP databases.The search keywords were gamma 3,gamma 3 U blade,and intertrochanteric fracture.Additionally,literature tracking was performed on the references of published literature.The data were analyzed using Revman 5.3 software.Two individuals checked the inputs for accuracy.Continuous variables were described using mean difference and standard deviation,and outcome effect sizes were expressed using ratio OR and 95%confidence interval(CI).High heterogeneity was considered at(P<0.05,I2>50%),moderate heterogeneity at I2 from 25%to 50%,and low heterogeneity at(P≥0.05,I2<50%).RESULTS Following a comprehensive literature search,review,and analysis,six articles were selected for inclusion in this study.This selection comprised five articles in English and one in Chinese,with publication years spanning from 2016 to 2022.The study with the largest sample size,conducted by Seungbae in 2021,included a total of 304 cases.Statistical analysis:A total of 1063 patients were included in this meta-analysis.The main outcome indicators were:Surgical time:The Gamma3U blade system had a longer surgical time compared to Gamma3 nails(P=0.006,I2=76%).Tip-apex distance:No statistical significance or heterogeneity was observed(P=0.65,I2=0%).Harris Hip score:No statistical significance was found,and low heterogeneity was detected(P=0.26,I2=22%).Union time:No statistical significance was found,and high heterogeneity was detected(P=0.05,I2=75%).CONCLUSION Our study indicated that the Gamma3 system reduces operative time compared to the Gamma3 U-blade system in treating intertrochanteric fractures.Both surgical methods proved to be safe and effective for this patient group.These findings may offer valuable insights and guidance for future surgical protocols in hip fracture patients.
文摘目的：观察加长Gamma3髓内钉闭合复位在股骨粗隆下粉碎性骨折中的应用效果。方法选择我院2010年1月~2013年12月收治的80例股骨粗隆下粉碎性骨折患者为研究对象，均行闭合复位治疗，随机将其分为治疗组（n=46），行加长Gamma 3髓内钉治疗，对照组（n=34）行动力髋螺钉治疗，术后随访12个月，比较两组手术结果、骨折愈合时间、功能恢复及并发症等情况。结果两组手术时间[（57.34±11.52）min vs（67.25±18.38）min]、术中出血量[（145.78±28.57）mL vs （264.55±25.26）mL]、住院时间[（14.20±2.63）d vs （18.65±3.00）d]及骨折愈合时间[（10.38±2.46）周 vs（14.21±2.24）周]比较，差异有统计学意义（P＜0.05）。另外随访1年，两组功能恢复优良率（91.30% vs 82.35%）比较，差异无统计学意义（P＞0.05），但两组并发症发生率（2.17% vs 17.65%）比较，差异有统计学意义（P＜0.05）。结论股骨粗隆下粉碎性骨折应用加长Gamma 3髓内钉闭合复位治疗，功能恢复良好，并发症少，值得临床推广。
