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A Meta-Analysis of Dynamic Hip Screw and Proximal Femoral Nail for Treatment of Intertrochanteric Fractures

Yong-tao Zhang, Jing Niu, Xin-zhi Chen, Zai-jie Tian, Guo-yong Qiao, Wen-ge Wang, Zhi-jie Li

Department of Orthopaedics, Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, China (mainland)

Med Sci Rev 2015; 2:73-80

DOI: 10.12659/MSRev.894735

Available online:

Published: 2015-09-03


ABSTRACT: Background: The purpose of this meta-analysis was to compare the outcomes of dynamic hip screw (DHS) and proximal femoral nail (PFN) in the treatment of intertrochanteric fractures based on the current evidence.
Material and Methods: We searched for relevant studies in the following databases: Cochrane Library, Medline, Embase, and CNKI (China National Knowledge Infrastructure) up to May 2014. All randomized or quasi-randomized controlled trials comparing DHS and PFN in the treatment of intertrochanteric fractures were included. Data was extracted independently for meta-analysis. The software Stata 12.0 version was used to perform all the analyses.
Results: Seven trials involving 792 cases of intertrochanteric fractures treated by DHS fixation (418) and PFN fixation (374) were included in the meta-analysis. Tow implants had similar operation time, blood loss, and hospital stay. The rate of wound complication, lag screw cut-out, and reoperation was not significantly different between the 2 groups.
Conclusions: DHS fixation and PFN fixation show the similar effectiveness in the treatment of intertrochanteric fractures based on the current evidence. The outcomes will ultimately require a rigorous and adequately powered randomized controlled trial to verify our results.

Keywords: Femoral Fractures, Hip Fractures, meta-analysis, Nails