Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2024; 15(3): 285-292
Published online Mar 18, 2024. doi: 10.5312/wjo.v15.i3.285
Meta-analysis of the clinical efficacy of the Gamma3 nail vs Gamma3U-blade system in the treatment of intertrochanteric fractures
Xuan Wu, Bo Gao
Xuan Wu, Department of Orthopedic, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing 210000, Jiangsu Province, China
Bo Gao, Department of Orthopedic, The Affiliated Taizhou Second People's Hospital of Yangzhou University, Taizhou 225500, Jiangsu Province, China
Author contributions: Wu X Collect all the literature required for the study, provided the data analysis of the article, and put forward important opinions and suggestions on the discussion part of the article; Gao B participated in the study of the background part of the article, collated and revised the content of the article; Bo G provided financial support as the host of the project.
Supported by The Clinical Medical Science and Technology Development Fund Project of Jiangsu University, No. JLY2021185.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Gao, Doctor, Surgeon, Department of Orthopedic, The Affiliated Taizhou Second People's Hospital of Yangzhou University, No. 27 Jiankang Road, Jiangyan District, Taizhou 225500, Jiangsu Province, China. gaobo305@163.com
Received: December 1, 2023
Peer-review started: December 1, 2023
First decision: December 28, 2023
Revised: January 8, 2024
Accepted: February 5, 2024
Article in press: February 5, 2024
Published online: March 18, 2024
Abstract
BACKGROUND

The traditional Gamma3 nail is a mainstream treatment for femoral intertrochanteric fractures. Literature reports that the Gamma3U-blade system can increase the stability of the Gamma3 nail and reduce complication incidence. However, comparative studies between the Gamma3U-blade and Gamma3 systems are limited; hence, this meta-analysis was performed to explore the clinical efficacy of these two surgical methods.

AIM

To investigate the clinical efficacy of Gamma3 and Gamma3 U-blade for intertrochanteric fractures.

METHODS

A computerized search for Chinese and English literature published from 2010 to 2022 was conducted in PubMed, Cochrane, CNKI, Wanfang, and VIP databases. The search keywords were gamma 3, gamma 3 U blade, and intertrochanteric fracture. Additionally, literature tracking was performed on the references of published literature. The data were analyzed using Revman 5.3 software. Two individuals checked the inputs for accuracy. Continuous variables were described using mean difference and standard deviation, and outcome effect sizes were expressed using ratio OR and 95% confidence interval (CI). High heterogeneity was considered at (P < 0.05, I2 > 50%), moderate heterogeneity at I2 from 25% to 50%, and low heterogeneity at (P ≥ 0.05, I2 < 50%).

RESULTS

Following a comprehensive literature search, review, and analysis, six articles were selected for inclusion in this study. This selection comprised five articles in English and one in Chinese, with publication years spanning from 2016 to 2022. The study with the largest sample size, conducted by Seungbae in 2021, included a total of 304 cases. Statistical analysis: A total of 1063 patients were included in this meta-analysis. The main outcome indicators were: Surgical time: The Gamma3U blade system had a longer surgical time compared to Gamma3 nails (P = 0.006, I2 = 76%). Tip-apex distance: No statistical significance or heterogeneity was observed (P = 0.65, I2 = 0%). Harris Hip score: No statistical significance was found, and low heterogeneity was detected (P = 0.26, I2 = 22%). Union time: No statistical significance was found, and high heterogeneity was detected (P = 0.05, I2 = 75%).

CONCLUSION

Our study indicated that the Gamma3 system reduces operative time compared to the Gamma3 U-blade system in treating intertrochanteric fractures. Both surgical methods proved to be safe and effective for this patient group. These findings may offer valuable insights and guidance for future surgical protocols in hip fracture patients.

Keywords: Gamma3 nail, Gamma3U-Blade system, Femoral intertrochanteric fractures, Meta-analysis

Core Tip: The Gamma3U-Blade, representing the third generation of Gamma nails, possesses several notable features: the incorporation of self-tapping tension screws enhances fixation stability and lowers the risk of cutting out. Anti-screw nails are ingeniously designed to aid in compressing the fracture end. Additionally, the option of dynamic lock or static force lock is available. Despite these advancements, comparative studies between Gamma3 and Gamma3U-blade are limited. Therefore, a meta-analysis of the existing literature was conducted to compare the clinical efficacy of these two surgical methods.