Is It Necessary to Use Cement Augmentation in Internal Fixation for Trochanteric Fractures in the Elderly? A Systematic Review and Meta-Analysis.

Study Summary

5 randomized controlled trials (RCTs) including 509 patients aged over 65 years with trochanteric fractures were included in this systematic review and meta-analysis comparing internal fixation with cement augmentation versus internal fixation without cement augmentation. Pooled outcomes of interest included fixation failure, tip-apex distance (TAD), mortality, reoperation, length of hospital stay, intraoperative blood loss, and operative time. Cement augmentation significantly reduced TAD but increased operative time. However, no statistically significant differences were observed in fixation failure, mortality, reoperation, hospital stay, or blood loss. Overall, cement augmentation improved a radiographic measure of implant positioning without demonstrating clear improvements in clinical outcomes, suggesting that its use should be individualized according to fracture characteristics and patient risk factors.