International Orthopaedics

, Volume 30, Issue 2, pp 69–78 | Cite as

Are short femoral nails superior to the sliding hip screw? A meta-analysis of 24 studies involving 3,279 fractures

  • Henry Wynn Jones
  • Philip Johnston
  • Martyn Parker
Original Paper


The purpose of this meta-analysis was to compare the fixation outcome between the sliding hip screw (SHS) and intramedullary nails (IMN) in stable and unstable extracapsular proximal femoral fractures. All randomised controlled studies comparing IMNs with a SHS were considered for inclusion. Data was independently extracted and trial methodology assessed. Twenty-four randomised trials involving 3,202 patients with 3,279 fractures were included. Pooled results gave no statistically significant difference in the cut-out rate between the IMN and SHS (41/1,556 vs 37/1,626; relative risk 1.19; 95% confidence interval 0.78–1.82). Total failure rate (1,03/1,495 and 58/1,565, relative risk 1.83; 95% confidence interval 1.35–2.50) and re-operation rate (57/1,357 and 35/1,415, relative risk 1.63; 95% confidence interval 1.11–2.40) were greater with the IMN compared with the SHS. There was no evidence for a reduced failure rate with IMN in unstable trochanteric fractures.


Le but de cette méta-analyse était de comparer le résultat de la fixation par vis glissante et clou centromédullaire dans les fractures extracapsulaires fémorales proximales stables et instables. Toutes les études randomisées et contrôlées qui comparent des clous centromédullaires avec une vis glissante ont été considérées pour l’inclusion. Les données ont été extraites indépendamment, et la méthodologie de l’étude étudiée. 24 essais randomisés qui concernent 3,202 malades avec 3,279 fractures ont été inclus. Les résultats mis en commun n’ont donné aucune différence statistiquement notable entre le clou centromédullaire et la vis glissante (41/1,556 vs 37/1,626; risque relatif 1.19; 95% intervalle de confidence 0.78–1.82). Le taux d’échec total (103/1,495 vs 58/1,565, risque relatif 1.83; 95% intervalle de confiance 1.35–2.50) et tle aux de la ré - opération (57/1,357 vs 35/1,415, risque relatif 1.63; 95% intervalle de confiance 1.11–2.40) étaient plus grands avec le clou centromédullaire comparé a la vis glissante. Il n’y avait aucune preuve qu’il y ait un taux de défaillance réduit avec le clou centromédullaire dans les fractures trochanterienne instables.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Henry Wynn Jones
    • 1
  • Philip Johnston
    • 2
  • Martyn Parker
    • 3
  1. 1.Department of OrthopaedicsBedford HospitalBedfordUK
  2. 2.Department of OrthopaedicsNorfolk and Norwich University HospitalColney, Norwich NorfolkUK
  3. 3.Department of OrthopaedicsPeterborough District HospitalPeterborough, CambridgeshireUK

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