Comparison of outcomes of Long versus Short Cephalomedullary nails for the fixation of intertrochanteric femur fractures: A Protocol for Systematic Review and Meta-analysis

Background The incidence of intertrochanteric femur fracture (IFF) in the elderly has increased with increased life expectancy globally. These fractures require surgeries at the earliest to bring them out of bed and minimize the complications of recumbency, like decubitus ulcers, decreased cardiopulmonary reserves, and thromboembolic events. Dynamic hip screws and Cephalomedullary nails (CMN) are both considered adequate for the internal fixation of the stable IFF with comparable stability and outcomes. However, CMNs are considered to have better results in unstable IFF fixation. Objective To compare the outcomes of internal fixation of short CMN versus long CMN of IFF in the elderly by analyzing the evidence from the current literature. Methods A systematic review and meta-analysis will be performed in accordance with the PRISMA guidelines. A primary search of Medline, Embase, Scopus, and Cochrane Library databases will be conducted using a pre-defined search strategy. The studies of any design in the English language will be included, which have compared the outcomes of the internal fixation of short CMN versus long CMN of the IFF and reported at least one primary or secondary outcome of interest. Studies that did not compare the outcomes of the internal fixation of short CMN versus long CMN of the IFF, conference abstracts, posters, case reports, book chapters, technical tips, review articles, biomechanical studies, cadaveric studies, and the articles not in the English language will be excluded. Both qualitative and quantitative analyses will be performed. A qualitative analysis will be performed using appropriate tables and diagrams. Wherever feasible, quantitative analysis will be done with the appropriate software. The risk-of-bias assessment for non-randomized comparative studies will be done using the MINORS tool, and the Cochrane Collaboration’s risk-of-bias tool will be used for randomized control trials (RCT).