Lira RJM, Arenas DR, Montero OY

Language: Spanish
References: 18
Page: 115-119
PDF size: 174.59 Kb.

ABSTRACT

Objective: To compare functional results, hemorrhage, wound infection, post-operative complications and implant stability in 31A1 and 31A2 fractures treated with percutaneous compression plate or dynamic hip screw. Material and methods: We made a cuasi-experimental, longitudinal, prospective and comparative study in a period from December 2004 to February 2005. Statistical analysis: System SPSS version 11.0, with t Student, Xi square and U Mann-Whitney, with alpha 0.05. Results: We included 26 patients with AO 31A1 and 31A2 fractures, 13 treated with percutaneous compression plate and 13 with dynamic hip screw. We did not found significant statistical difference in post-operative hospital stay; wound length, post-operative complications and consolidation time. There were no infection or other wound complications in either group. Time of surgery and hemorrhage were better in the percutaneous compression plate group (p ≤ 0.05). Conclusions: Percutaneous compression plate offers similar functional results compared to the dynamic hip screw, with advantages in hemorrhage during surgery and after surgery, less surgery time, with less need of transfusions post-operatively.

REFERENCES

1. Cooper C: Hip fractures in the elderly a world-wide projection. Osteoporosis Int 1992; 2: 285-9.

2. Hinton RY, Smith GS: The association of age, race, and sex with the location of proximal femoral fractures in the elderly. J Bone Joint Surg Am 1993; 75: 752.

3. Roger Cornwell: Functional Outcomes and mortality vary among different types of hip fractures. Clin Orthop Relat Res 2004; 425: 64-71.

4. Bendo JA: Collapse of intertrochanteric hip fracture fixed with sliding screw. Orthop Rev 1994; (suppl 1): 30-7

5. Gotfried Y: The lateral trochanteric wall: A key element in the reconstruction of unstable pertrochanteric fracture. Clin Orthop Relat Res 2004; 425: 828.

6. Gotfried Y. Percutaneous compression plating for Intertrochanteric hip fractures: Treatment rationale. Orthopaedics 2002; 25: 647-52.

7. Roger C: Functional Outcomes and mortality vary among different types of hip fractures. Clin Orthop Relat Res 2004; 425: 64-71.

8. Madsen C: Dynamic compression plate vs. Gamma nail in the treatment of pertrochanteric fractures: Comparative study. J Orthop Trauma 1998; 14: 123.

9. Leung K: Gamma nail and dynamic hip screw for pertrochanteric fractures: A randomized prospective study in elderly patients. J Bone J Surg Am 1992; 74: 345-51.

10. Baumgarten MR: Intramedullary fixation for the treatment of intertrochanteric fractures. Clin Orthop Relat Res 1998; 348: 87-94.

11. Janzin HMJ, Houben BH, Gotfried Y: The Gotfried percutaneous compression plate versus the dynamic hip screw in the treatment of pertrochanteric hip fractures: minimal invasive treatment reduces operative time and postoperative pain. J Trauma 2002; 52: 293-8.

12. Gotfried Y: Percutaneous compression plating of intertrochanteric hip fracture. J Orthop Trauma 2000; 14: 490-5.

13. Brand SE, Lefever S, Janzing H: Percutaneous compression plating (PCCP) versus dynamic hip screw for pertrochanteric hip fracture preliminary results. Injury 2002; 33: 413-8.

14. Peyser A, Weil Y, Manor O: Percutaneous compression plating versus compression hip screw fixation for the treatment of intertrochanteric hip fractures. Injury 2005; 36: 1343-9.

15. Gillespie W, Murria D, Gregg PJ, Warmick D: Risk and benefit of prophylaxis against venous thromboembolism in Orthopaedic surgery. J Bone Joint Surg (Br) 2000; 82(B): 475-9.

16. Marc S: Pertrochanteric fractures: Is there an advantage to an intramedullary nail. J Orthop Trauma 2002; 16: 386-93.

17. Kenzora JE, McCarthy RE, Lowell JD, Sledge CB: Hip fracture mortality: relation to age, treatment, preoperative illness, time of surgery, and complications. Clin Orthop Relat Res 1984; 186: 45-56.

18. Campbell, James L. Guyton: Cirugía Ortopédica, Novena Edición, Nueva York, Interamericana, 2000; 48: 2189-94.