A Systematic Review of Methods of Fixation of Greater Trochanter Fracture during Hip Arthroplasty

Abstract

Abstract Background The rigid fixation of greater trochanter has been supported by more and more surgeons, but the choice of fixation is still controversial. Traditional steel wires and titanium is widely used because of its relatively simple procedure and low cost. But the high failure rate of internal fixation also led orthopedists to seek for other more effective fixation methods. Objective To compare between methods of fixation of greater trochanter during hip arthroplasty according to type and postoperative outcome. Patients and Methods Studies that meet the inclusion criteria were reviewed and data were analysed. We assessed the participants, methods, and intervention effects of included studies for heterogeneity. This enabled us to determine whether results can be pooled across studies. Results This review was on Non randomized and randomized controlled trials, prospective and retrospective studies which compare different methods of fixation of trochanter during hip arthroplasty. The search strategy identified 780 unique citations. Screening of titles and Abstracts identified 93 potentially relevant articles. Full text review of these articles identified 10 studies meeting the inclusion criteria. 10 studies were included 8 were retrospective and 2 prospective studies. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion The different fixation methods were successful in achieving proper reduction and fixation of greater trochanteric fractures during hip arthroplasty. We preferred the cable plates, which not only provides strongest fixation but also results in lower rate of postoperative complications. But further prospective randomized and cohort studies are needed to validate their safety and efficacy.