Medial femoral plate with cannulated screw for Pauwels type III femoral neck fracture: A meta-analysis

BACKGROUND: Femoral neck fractures often occur in the elderly, which usually results in hip pain. OBJECTIVE: The purpose of this study was to evaluate the difference in the treatment of Pauwels type III femoral neck fractures with medial femoral support plate combined with cannulated screws and cannulated screws alone. METHODS: PubMed, ScienceDirect, China Academic Journals Full-text Database (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Embase and Cochrane Library were used to collect clinical controlled trials of the medial femoral support plate combined with hollow screw internal fixation and simple hollow screw internal fixation for Pauwels type III femoral neck fracture. RESULTS: Seven articles (n = 409 cases) were evaluated for quality and included in this meta-analysis. Four hundred and nine patients with Pauwels type III femoral neck fractures were included: 202 in the experimental group and 207 in the control group. The results showed that, compared with simple hollow screw internal fixation, the medial femoral support plate combined with hollow screw internal fixation has a longer operation time (MD = 23.05, 95% CI = 13.86-32.24), and more intraoperative blood loss (MD = 91.55, 95% CI = 50.72-132.39), shorter healing time (MD = -1.48, 95% CI ( 1.71, 1.26)), lower incidence of complications (RR = 0.34, 95% CI = 0.19-0.61), lower VAS score (MD = -1.28, 95% CI ( 1.83, 0.72)), and higher Harris score (MD = 8.49, 95% CI (4.15, 12.83)). CONCLUSION: Medial femoral plate combined with cannulated screw for Pauwels type III femoral neck fracture can shorten healing time, reduce postoperative complications, and improve the postoperative Harris score.