Cochrane · systematic review · CD000093
Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults
Lewis, SR, Macey, R, Gill, JR, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
8
current version
GRADE rated
7
No studies
1
Included studies
NR
No studies 1 · 12.5%Ungraded 0 · 0%Very low 2 · 25%Low 3 · 37.5%Moderate 2 · 25%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cephalomedullary nails compared to extramedullary implants for extracapsular hip fractures in adults
Population: older adults with stable or unstable extracapsular hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living (ADL), early (≤ 4 months): using LEM (range from 0 to 100), FIM (range from 0 to 100), JOA (range from 0 to 20); higher scores indicate better performance in ADL Cephalomedullary nails vs extramedullary implants | no estimate extracted | 4 studies · 509 participants | Very low Downgraded: inconsistency |
Delirium (at end of Cephalomedullary nails vs extramedullary implants | RR 1.22 [0.67, 2.22] | 5 studies · 1310 participants | Low Downgraded: imprecision |
Functional status, early (≤ 4 months): using Zűckerman functional recovery score (0 to 44), and 100‐point functional recovery scale; in both scales, higher scores indicate better function Cephalomedullary nails vs extramedullary implants | SMD 0.02 | 2 studies · 188 participants | Low Downgraded: imprecision |
Health‐related quality of life, early (≤ 4 months) Cephalomedullary nails vs extramedullary implants | no estimate extracted | NR | No studies |
Mobility (≤ 4 months): assessed as number of participants with independent mobility Cephalomedullary nails vs extramedullary implants | RR 1.12 [1.01, 1.23] | 7 studies · 719 participants | Very low Downgraded: inconsistency |
Mortality, early (≤ 4 months) Cephalomedullary nails vs extramedullary implants | RR 0.96 [0.79, 1.18] | 30 studies · 4603 participants | Moderate |
Mortality at 12 months Cephalomedullary nails vs extramedullary implants | RR 0.99 [0.9, 1.08] | 47 studies · 7618 participants | Moderate |
Unplanned return to theatre (at end of Cephalomedullary nails vs extramedullary implants | RR 1.15 [0.89, 1.5] | 50 studies · 8398 participants | Low Downgraded: risk of bias, imprecision |