Liang Mingzhou,Li Yang,Liu Xiaoyang.Efficacy of hollow screw versus locking compression hip plate for displaced pediatric femoral neck fracture:a Meta-analysis[J].Journal of Clinical Pediatric Surgery,,():558-566.[doi:10.3760/cma.j.cn101785-20260306-00091]
Efficacy of hollow screw versus locking compression hip plate for displaced pediatric femoral neck fracture:a Meta-analysis
- Keywords:
- Femoral Neck Fractures; Fracture Fixation; Meta-Analysis
- Abstract:
- Objective To systematically evaluate the efficacy of hollow screws versus locking compression hip plate for displaced pediatric femoral neck fractures using meta-analysis. Methods The relevant literature published from database inception to July 30,2025,comparing cannulated screws with pediatric hip locking compression plate (LCP-PHP) for displaced pediatric femoral neck fractures was systematically searched across the following databases of China National Knowledge Infrastructure,Chinese Biomedical Literature Database,VIP,WANFANG,PubMed,Embase,Web of Science and Cochrane Library.Inclusion criteria:① age<18 years,diagnosed with displaced femoral neck fracture and operated; ② randomized controlled trials,cohort studies or case-control studies; ③ comparison between hollow screw fixation and LCP-PHP fixation; ④ reporting at least one outcome of interest in this study.After study selection,methodological quality of included articles was assessed using the Newcastle-Ottawa Scale (NOS).Data pertaining to outcome measures were extracted.Meta-analyses was performed using RevMan software (Version 5.4) and Stata (Version 18.0) for comparing outcomes between two intervention groups,including:operative duration,incision length,intraoperative volume of blood loss,fracture healing time,quality of fracture reduction (excellent/good rate),Harris Hip Score,neck-shaft angle loss,favorable rate based upon Ratliff criteria,overall complication rate,incidence of femoral head osteonecrosis,incidence of coxa vara and incidence of premature physeal closure. Results Among 9 studies,8 were published in Chinese and 1 in English,all being retrospective cohort studies.And 531 pediatric displaced femoral neck fracture cases (317 treated with cannulated screws,214 with LCP-PHP) were included.Meta-analysis revealed that cannulated screws had shorter operative duration (WMD=-21.26,95%CI:-36.92 to-5.60,P=0.008),smaller incision length (WMD=-2.77,95%CI:-3.12 to-2.41,P<0.00001) and less intraoperative volume of blood loss (WMD=-21.17,95%CI:-34.36 to-7.99,P=0.002) versus LCP-PHP.Conversely,LCP-PHP demonstrated a higher Ratliff excellent/good rate (OR=0.32,95%CI:0.12 to 0.82,P=0.02) and less loss of neck-shaft angle (WMD=1.54,95%CI:1.43 to 1.64,P<0.00001).No significant differences existed in fracture healing time,excellent/good fracture reduction rate,Harris hip scores,total complications,femoral head necrosis,coxa vara or premature physeal closure between two fixation modes (P>0.05). Conclusion For displaced pediatric femoral neck fractures,cannulated screws offer advantages in shorter operative duration,minimal incision and less volume of blood loss while LCP-PHP demonstrates superior long-term hip function outcomes and lower neck-shaft angle loss.
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Memo
收稿日期:2026-3-6。
通讯作者:刘潇阳,Email:202335848@mail.sdu.edu.cn