***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Nineteen trials, of which two were newly included in this update, involving 3044 participants, were included. There was considerable variation in the types of implants and techniques used for both internal fixation and arthroplasty in the included trials. The risk of selection bias was low in just three trials, unclear in 13 trials and high in the three quasi-randomised trials. Just three trials reported assessor blinding of functional outcomes. Length of surgery, operative blood loss, need for blood transfusion and risk of deep wound infection were significantly less for internal fixation compared with arthroplasty. Fixation had a significantly higher re-operation rate in comparison with arthroplasty (40% versus 11%; risk ratio 3.22, 95% CI 2.31 to 4.47, 19 trials). No definite differences for hospital stay, mortality, or regain of pre-injury residential state were found. Limited information from some studies suggested pain was less and function was better for a cemented arthroplasty in comparison with fixation. Internal fixation is associated with less initial operative trauma but has an increased risk of re-operation on the hip. Definite conclusions cannot be made for differences in pain and residual disability between the two groups. Future studies should concentrate on better reporting of final outcome measures and function. There is still a need for studies to define which patient groups are better served by the different treatment methods.
Output:

Nineteen trials, of which two were newly included in this update, involving 3044 participants, were included in this review. Some trials had weak methods, which required a more cautious interpretation of their results. There were many different types of devices and methods used to place these devices for both treatments in the included trials. We found that each treatment has its own specific complications. Realigning the bones and fixing the fracture (reduction and internal fixation) is a shorter operation with less blood loss. However, people having internal fixation are more likely to need another operation than those treated with joint replacement (40% versus 11%). The reason for this is mainly from a failure of the bone to heal in those cases treated with fixation. No definite differences were found between the two treatment groups in the numbers of patients who had died by various follow-up times. People who had a replacement with an artificial hip joint that was fixed in place with cement seemed to have less residual pain and better function related to using the hip than those whose fracture was fixed. There is not enough evidence to be sure whether fixation of the bone or replacement with an artificial hip is best for treating fractures of the thigh bone near the hip joint.