Nicholas Dominguez, Ruurd Jaarsma, Anum Awais, Vanesa Bochkezanian, Edoardo Aromataris
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引用次数: 0
Abstract
Objective: The objective of this review is to evaluate the effect of revision surgical strategies compared on functional outcomes, health-related quality of life, and postoperative complications in patients aged 65 years and older with failed primary fixation of trochanteric femoral fractures.
Introduction: Trochanteric fractures of the femur, including both intertrochanteric and pertrochanteric fractures, are prevalent in older populations and frequently require surgical intervention. Despite initial surgical efforts, failures often occur and revision surgery may be required.
Eligibility criteria: This systematic review will include randomized controlled trials, quasi-experimental designs, prospective and retrospective cohort studies and case control studies. Studies will be included if they assess surgical revision strategies following failed primary fixation of trochanteric femoral fractures, including intertrochanteric and pertrochanteric fractures, in patients aged 65 years and above. Any surgical method for revision will be compared against other surgical revision strategies.
Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and AgeLine will be searched for eligible studies. Titles and abstracts will be screened, followed by a full-text review of potentially eligible studies by 2 independent reviewers. Critical appraisal of studies will be conducted independently by the same reviewers guided by the JBI critical appraisal tools. Data will be meta-analyzed statistically, if appropriate; where meta-analysis is not possible, vote counting based on the direction of effect will be used as a quantitative synthesis approach, with supporting narrative. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) will be utilized to assess the certainty of the synthesized results.
目的：本综述的目的是评估翻修手术策略对65岁及以上原发性股骨粗隆骨折固定失败患者的功能结局、健康相关生活质量和术后并发症的影响。股骨粗隆骨折，包括粗隆间骨折和粗隆后骨折，在老年人中很常见，经常需要手术干预。尽管最初的手术努力，失败经常发生，可能需要翻修手术。入选标准：本系统综述将包括随机对照试验、准实验设计、前瞻性和回顾性队列研究以及病例对照研究。在65岁及以上患者中，如果评估股骨粗隆骨折（包括粗隆间骨折和粗隆间骨折）初次固定失败后的手术翻修策略，将纳入研究。任何手术翻修方法都将与其他手术翻修策略进行比较。方法：检索PubMed、Embase、Cochrane Central Register of Controlled Trials （Central）和AgeLine，寻找符合条件的研究。将对标题和摘要进行筛选，然后由2名独立审稿人对可能符合条件的研究进行全文审查。研究的关键评估将由相同的审稿人在JBI关键评估工具的指导下独立进行。如有必要，将对数据进行meta分析；在不可能进行meta分析的情况下，基于效果方向的计票将被用作定量综合方法，并附有支持性叙述。将利用建议、评估、发展和评价分级（GRADE）来评估综合结果的确定性。评审注册：PROSPERO （CRD420251250047）。
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