Open Reduction versus Closed Reduction with Internal Fixation for Femoral Neck Fracture: A Systematic Review and Meta-Analysis


  • Harvy Harvyandani Medical Faculty University of Muhammadiyah Malang
  • Muhammad Tholhah Azam Medical Faculty University of Muhammadiyah Malang, Malang, Indonesia
  • Farizky Jati Ananto Medical Faculty University of Muhammadiyah Malang, Malang, Indonesia
  • Probo Yudha Pratama Putra Medical Faculty University of Muhammadiyah Malang, Malang, Indonesia



ORIF, CRIF, Femoral Neck Fracture, Treatment


Introduction & Objective:
A femoral neck fracture is a fracture that has many complications which are quite dangerous. Complications often include avascular necrosis, osteonecrosis, non union fractures, and coxa-vara. However, until now, the management of femoral neck fractures is still controversial, using the ORIF or CRIF methods. This meta analysis aims to compare the occurrence of postoperative non-union, malunion (coxa-vara), and avascular necrosis between ORIF and CRIF.

Material & Method:
A systematic review was done according to the PRISMA guideline diagram and flowchart; a literature review was conducted in May 2023 using PubMed, Science Direct, Cochrane Library, Google Scholar, and Biomedcentral (BMC) —minimum publishing year 20 years. The meta-analysis procedure was carried out and processed using the RevMan V.5.3 program.

A total of 203 ORIF cases and 396 CRIF cases from the results of 7 studies. There was a significant difference in the incidence of union (RR 0.44, 95% CI 0.22 to 0.86, p =0.02) as well as the incidence of malunion (coxa-vara) there was a significant difference (RR 0.13, 95% CI 0.02 to 0.73, p = 0.02 ). Whereas in the event of avascular necrosis (AVN), there was no significant difference OR 1.06, 95% CI 0.49 to 2.29, p= 0.08).

ORIF has better effectiveness and safety than CRIF regarding the number of postoperative non-union and malunion (coxa-vara) events.


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