Amigo CP, Rodríguez DM, Reguera RR, Fernández VO

Language: Spanish
References: 17
Page: 156-166
PDF size: 89.63 Kb.

ABSTRACT

Introduction: traumatological surgery is one of the most common treatments in hip fractures.
Objective: select the appropriate implant for the surgical treatment of hip fractures.
Methods: a prospective longitudinal study was conducted with all the patients admitted with hip fracture (535 patients in all) from 1 January 2009 to 31 December 2010. The sample consisted of 163 patients meeting the inclusion criteria.
Results: a predominance was found of the female sex (60 %) and the 70-79 age group in both sexes (36 %). Extracapsular fractures predominated (74 %). The most common implant in this group was the Gt intramedullary nail, whereas simple prostheses were more common in intracapsular fractures (36 %). In 90 % of cases surgical time was under 2 hours. 97 % of patients were discharged within 5 days. 12.8 % had complications, the most common of which was wound hematoma, found in several implants.
Conclusions: use of the foot to support body weight was indicated in all biarticular prosthesis cases within 30 days. The last patients to rest their foot on the floor were those with spongy screws or spongy screws plus Ender nails. 14.7 % of patients died within the year following surgery, patients with 130º and 95º plates representing the highest percentage (32 %).

REFERENCES

1. Sebastián Muñoz G, Jorge Lavanderos F, Loreto Vilches A, Miguel Delgado M, Karina Cárcamo H, Stephania Passalaqua H, et al . Fractura de cadera. Cuad Cir. 2008;22:73-81.

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

3. Egol KA, Koval KJ, Zuckerman JD. Functional recovery following hip fracture in the elderly. J Orthop Traum. 1997;11:594-9.

4. Scaf-Klomp W, Sanderman R, OrmelJ, Kempen GL. Depression in older people after fall-related injuries: a prospective study. Age Ageing. 2003;32:88-94.

5. Zuckerman JD. Hip Fracture. NEJM. 1996;33(23):1519-25.

6. Parker MJ, Blundell C. Choice of implant for internal fixation of femoral neck fractures meta analysis of 25 randomized trials including 4925 patients. Acta Orthop Scand. 1998;69:138-43.

7. Raaymakers EL, Marti PK. Non-operative treatment of impacted femoral neck fractures. A prospective study of 170 cases. J Bone Joint Surg Br. 1991;73:950-4.

8. Hui AC, Anderson GH, Choudhry R, Boyle J, Gregg PJ. Internal fixation or hemiarthroplasty for undisplaced fractures of the femoral neck in octogenarians. J BoneJoint Surg Am. 1994;76:891-4.

9. Rogmark C, Carlsson A, Johnell O, Sernbo I. Primary hemiarthroplasty in old patients with displaced femoral neck fracture. A 1 year follow-up of 103 patients aged 80 years or more. Acta Orthop Scand. 2002;73:605-10.

10. Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: a randomised prospective study. J Bone Joint Surg Br. 1996;78:391-4.

11. Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochantheric region of the femur. J Bone Joint Surg Am. 2001;83:643-50.

12. Sadowski C, Lubbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of reverse oblique and transverse interthochanteric fractures with use of an intramedullary nail or and 95 degrees screw-plate: a prospective, randomised study. J Bone Joint Surg Am. 2002;84:372-81.

13. Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowtz R. The proximal femoral nail (PFN)- a minimal treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand. 2003;74:53-8.

14. Parker MJ, Handol HH. Extramedullary fixation implants and fixators for extracapsular hip fractures (Cochrane Review). The Cochrane Library, Issue 4.Oxford: Update Software; 2002.

15. Saundan M, Lubbeke A, Sadowski C, Rinad N, Stern R, Hoffmeyer P. Pertrocantheric fractures: is there and advantage to an intramedullary nail?: a randomised, prospective study of 206 patients comparing the dynamic hip screw and pro-ximal femoral nail. J Orthop Trauma. 2002;16:386-93.

16. Parker MJ, Handoll HHG, Boonsle S Gillespie W J. Extracapsular proximal femoral fractures: condylocephalic nails (Ender o Harris nails) versus extramedullary implants (fixed nail plates or sliding hip screws) (Cochrane Review). The Cochrane Library, Issue 4. Oxford: Update Software; 1998.

17. Eder S, Frankenburg E, Goulet J, Yetkinler D, Poser R, Goldstein S. Biomechanical evaluation of calcium phosphate cement- augmented fixation of unstable intertrochanteric fractures. J Orthop Trauma. 2000;14:386-93.