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Open Access Research article

Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis

Weiguo Wang12, Junjie Wei3, Zhanwang Xu4*, Wenkun Zhuo1, Yuan Zhang1, Hui Rong1, Xuecheng Cao1 and Pingshan Wang1

Author Affiliations

1 Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China

2 Research on 2013 stage doctoral student of TCM Orthopaedics, Shandong University of Traditional Chinese Medicine, Jinan, China

3 Outpatient Department, General Hospital of Jinan Military Command, 250031 Jinan, China

4 Department of Orthopaedics, The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, NO.16369, Jingshi Road, 250014 Jinan, China

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BMC Musculoskeletal Disorders 2014, 15:167  doi:10.1186/1471-2474-15-167

Published: 22 May 2014



A meta-analysis was performed to assess the association between healing rate, avascular necrosis (AVN) of femoral head and two reductions-open reduction internal fixation (ORIF) and closed reduction internal fixation (CRIF) for femoral neck fracture.


A literature-based search was conducted to identify all relevant studies published before September 10, 2013. The odd ratio (OR) and 95% confidence interval (CI) were used for estimating the effects of the two reduction methods. Data were independently extracted by two investigators who reached a consensus on all of the items. The heterogeneity between studies was examined by χ2-based Q statistic. Egger’s regression analysis was used to evaluate publication bias. Statistical analysis was performed by Stata 10.0 software.


We examined 14 publications. The results of the present meta-analysis showed that AVN of femoral head were significant associated with the two reductions (CRIF vs. ORIF, OR = 1.746, 95% CI 1.159-2.628, p = 0.008), while the healing rate were not (CRIF vs. ORIF, OR = 0.853, 95% CI 0.573-1.270, p = 0.433).


The present meta-analysis indicated the risk of AVN of femoral head was significant higher after CRIF fixation compared with ORIF, but no association between the healing rate and the two reductions for femoral neck fracture.

Femoral neck fracture; Open reduction internal fixation; Closed reduction internal fixation