Abstract
BACKGROUND: Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) is widely used for the treatment of femoral neck fractures. AIM: This study conducted a comparative and meta-analysis of the therapeutic effects of different screw fixation methods in femoral neck fractures, with the aim of finding a better treatment. METHODS: Pubmed, Embase, Cochrane Library and Web of science databases were searched using MeSH Terms combined with free words without time or language constraints. MeSH Terms were "femoral neck fractures", "Sliding Hip Screw", "Cancellous Screws", "Fixation using Alternative Implants for the Treatment of Hip fractures", "over 50 years old". The search deadline is August 15, 2024. Two researchers sifted through the retrieved literature to come up with the included literature. After a close reading of the literature, Review Manager 5.4 was used to analyze the risk of bias in the included literature, compare various indicators of different screw fixation, and make forest and funnel maps. RESULTS: 214 literatures were retrieved from 4 databases were included in the study after screening. The bias of the included literature is good, and the randomness and blindness are clearly indicated in this paper. Pauwels Type III (Chi(2) = 0.00, df = 3, I(2) = 0%, z = 0.80, p = 0.43), fall (Chi(2) = 2.23, df = 2, I(2) = 10%, z = 1.88, p = 0.06) and Mortality (Chi(2) = 4.80, df = 2, I(2) = 58%, z = 3.53, p = 0.0004) were lower in sliding hip screws than in cancellous screws. Garden type III and IV (Chi(2) = 1.37, df = 3, I(2) = 0%, z = 0.71, p = 0.48) and Infection (Chi(2) = 0.01, df = 2, I(2) = 0%, z = 0.28, p = 0.78) were lower in sliding hip screws than in cancellous screws (Both p > 0.05). CONCLUSIONS: In Femoral neck fractures, sliding hip screws have a distinct advantage over cancellous screws. This has guiding significance for clinical treatment. Elderly patients with femoral neck fractures should be given priority for fixation with sliding hip screws.