No advantages of Gamma nail over sliding hip screw in the management of peritrochanteric hip fractures: a meta-analysis of randomized controlled trials

PURPOSE: There is a lack of consensus regarding the best option for the operative treatment of peritrochanteric fractures. A meta-analysis was performed to assess the surgical outcomes of peritrochanteric fractures.

METHODS: Only prospective, randomized studies comparing Gamma nail and sliding hip screw (SHS) fixation in adults were included. Eleven studies met the inclusion criteria: the target population consisted of patients with peritrochanteric fractures, while subtrochanteric fractures were not included; the intervention was SHS compared with Gamma nail; the study was a published randomized trial. Each outcome measure tested was assessed for heterogeneity. If significant heterogeneity was present, data from the studies were not combined. If there was no significant heterogeneity, a combined relative risk was calculated using a fixed effects model and a Z-test was performed to test the overall effect.

RESULTS: A total of 1344 peritrochanteric fractures entered into the included studies. There were no differences of mortality, cut-out, non-union, re-operation, wound infection, intra-operative fractures of femur, blood loss or surgical time.

CONCLUSIONS: It seemed that there were no obvious advantages of Gamma nail fixation over SHS fixation in treating peritrochanteric fractures.