Cochrane · systematic review · CD013409
Internal fixation implants for intracapsular hip fractures in older adults
Lewis, SR, Macey, R, Eardley, WGP, et al. · Cochrane Database of Systematic Reviews · 2021 · 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
32
current version
GRADE rated
19
No studies
13
Included studies
NR
No studies 13 · 40.6%Ungraded 0 · 0%Very low 10 · 31.3%Low 9 · 28.1%Moderate 0 · 0%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
Smooth pins compared with fixed angle plates for intracapsular hip fractures in older adults
Population: older adults (> 60 years of age) with displaced and undisplaced intracapsular hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living Smooth pins vs fixed angle plates | no estimate extracted | NR | No studies |
Delirium Smooth pins vs fixed angle plates | no estimate extracted | NR | No studies |
Functional status Smooth pins vs fixed angle plates | no estimate extracted | NR | No studies |
HRQoL Smooth pins vs fixed angle plates | no estimate extracted | NR | No studies |
Mobility: Use of no mobility aids or 1 walking stick only Smooth pins vs fixed angle plates | RR 0.98 [0.78, 1.22] | 1 study · 112 participants | Very low Downgraded: risk of bias, imprecision |
Mortality: early(within 4 months) Smooth pins vs fixed angle plates | RR 1.32 [0.67, 2.62] | 1 study · 383 participants | Very low Downgraded: risk of bias, imprecision |
Mortality: at 12 months Smooth pins vs fixed angle plates | RR 0.93 [0.47, 1.87] | 2 studies · 661 participants | Very low Downgraded: risk of bias, imprecision |
Unplanned return to theatree Smooth pins vs fixed angle plates | RR 0.77 [0.56, 1.06] | 3 studies · 736 participants | Very low Downgraded: risk of bias, imprecision |
Screws compared with fixed angle plates for intracapsular hip fractures in older adults
Population: older adults (> 60 years of age) with displaced and undisplaced intracapsular hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living Screws vs fixed angle plates | no estimate extracted | NR | No studies |
Delirium Screws vs fixed angle plates | no estimate extracted | NR | No studies |
Functional status: using WOMAC (range from 0 to 96, lower scores indicate better function) Screws vs fixed angle plates | no estimate extracted | 2 studies · 498 participants | Low Downgraded: risk of bias, imprecision |
HRQoL: using EQ‐5D (range from 0 to 1; higher values indicate better quality of life Screws vs fixed angle plates | no estimate extracted | 2 studies · 521 participants | Low Downgraded: risk of bias, imprecision |
Mobility: walking as before fracture, or using 1 walking stick now and no walking aids before fracture Screws vs fixed angle plates | RR 0.66 [0.35, 1.25] | 1 study · 70 participants | Very low Downgraded: risk of bias, imprecision |
Mortality: early (within 4 months) Screws vs fixed angle plates | RR 0.83 [0.44, 1.59] | 3 studies · 467 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 12 months (Data prioritised at 12 months, but in its absence we included data after 4 months and up to 24 months.) Screws vs fixed angle plates | RR 1.04 [0.83, 1.31] | 7 studies · 1690 participants | Low Downgraded: risk of bias |
Unplanned return to theatreg Screws vs fixed angle plates | RR 1.1 [0.95, 1.26] | 11 studies · 2321 participants | Low Downgraded: risk of bias |
Screws compared with smooth pins for intracapsular hip fractures in older adults
Population: older adults (> 60 years of age) with displaced and undisplaced intracapsular hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living Screws vs smooth pins | no estimate extracted | NR | No studies |
Delirium Screws vs smooth pins | no estimate extracted | NR | No studies |
Functional status Screws vs smooth pins | no estimate extracted | NR | No studies |
HRQoL Screws vs smooth pins | no estimate extracted | NR | No studies |
Mobility Screws vs smooth pins | no estimate extracted | NR | No studies |
Mortality: early (within 4 months) Screws vs smooth pins | RR 1.22 [0.79, 1.89] | 3 studies · 584 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 12 months (Data prioritised at 12 months, but in its absence we included data after 4 months and up to 24 months.) Screws vs smooth pins | RR 1.07 [0.85, 1.35] | 6 studies · 1005 participants | Low Downgraded: risk of bias |
Unplanned return to theatred Screws vs smooth pins | RR 0.83 [0.5, 1.37] | 5 studies · 862 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Screws or pins compared with fixed angle plates for intracapsular hip fractures in older adults
Population: older adults (> 60 years of age) with displaced and undisplaced intracapsular hip fractures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Activities of daily living Screws or pins vs fixed angle plates | no estimate extracted | NR | No studies |
Delirium Screws or pins vs fixed angle plates | no estimate extracted | NR | No studies |
Functional status: using WOMAC (range from 0 to 96; lower values indicate improved function) Screws or pins vs fixed angle plates | no estimate extracted | 2 studies · 498 participants | Low Downgraded: risk of bias, imprecision |
HRQoL: using EQ‐5D (range from 0 to 1; higher values indicate better quality of life Screws or pins vs fixed angle plates | no estimate extracted | 2 studies · 521 participants | Low Downgraded: risk of bias, imprecision |
Mobility: one walking stick or none Screws or pins vs fixed angle plates | RR 0.89 [0.63, 1.26] | 2 studies · 182 participants | Very low Downgraded: risk of bias, imprecision |
Mortality: early (within 4 months) Screws or pins vs fixed angle plates | RR 1.04 [0.65, 1.66] | 4 studies · 850 participants | Very low Downgraded: risk of bias, imprecision |
Mortality at 12 months (Data prioritised at 12 months, but in its absence we included data after 4 months and up to 24 months.) Screws or pins vs fixed angle plates | RR 1.04 [0.85, 1.27] | 9 studies · 2351 participants | Low Downgraded: risk of bias |
Unplanned return to theatreg Screws or pins vs fixed angle plates | RR 1.02 [0.88, 1.18] | 14 studies · 3057 participants | Low Downgraded: risk of bias, imprecision |