Paper Title:
Comparing Dynamic Hip Screw to External Fixation for Treatment of Osteoporotic Pertrochanteric Fractures: A Prospective Randomized Study
  Abstract

External fixation has proven to be a viable minimally invasive treatment option for elderly patients with trochanteric fractures. Postoperative complications has limited external fixation in relation to inadequate pin fixation. We compared Orthofix pertrochanteric fixator (OPF) with hydroxyapatite-coated pins to dynamic hip screw (DHS) with AO/ASIF stainless-steel screws in osteoporotic trochanteric fractures. Methods: Forty patients were divided into two groups and randomized for treatment with 135° 4-hole DHS (Group A) or OPF with four hydroxyapatite-coated pins (Group B). Inclusion criteria was: female, age ≥ 65 years, AO fracture type A1 or A2 and BMD lower than -2.5 T-score. All fixators were removed at 3 months. Results: There were no differences in patient age, fracture type, BMD, ASA, hospital stay and reduction quality. Average number of blood transfusions was 2.0 ± 0.1 in Group A, whereas there were none in Group B (p < 0.0001). Operative time was 64 ± 6 minutes in Group A and 34 ± 5 in Group B (p < 0.005). Post-operative femoral neck shaft angle was 134 ± 6° in Group A, and 132 ± 4° in Group B (ns). In Group A, fracture varization at 6 months was 6 ± 8°, in Group B 2 ± 1° (p = 0.002). Harris hip score was 62 ± 20 in Group A and 63 ± 17 in Group B. (n.s.) In Group B, no pin infection occurred. Pin fixation was maintained over time, as shown by no significant difference between pin extraction and corresponding insertion torque. Discussion and Conclusion: In external fixation with hydroxyapatite-coated pins there was no need for blood transfusions and fixation was superior, as confirmed by less varization at long-term.

  Info
Periodical
Key Engineering Materials (Volumes 284-286)
Main Theme
Edited by
Panjian Li, Kai Zhang and Clifford W. Colwell, Jr.
Pages
1037-1040
DOI
10.4028/www.scientific.net/KEM.284-286.1037
Citation
A. Moroni, C. Faldini, F. Pegreffi, A. Hoang-Kim, F. Vannini, S. Giannini, "Comparing Dynamic Hip Screw to External Fixation for Treatment of Osteoporotic Pertrochanteric Fractures: A Prospective Randomized Study", Key Engineering Materials, Vols. 284-286, pp. 1037-1040, 2005
Online since
April 2005
Export
Price
$32.00
Share

In order to see related information, you need to Login.

In order to see related information, you need to Login.

Authors: Gregory Y. Lee, Ajay Srivastava, Darryl D. D'Lima, Pam Pulido, Clifford W. Colwell
Abstract:The Omnifit-HA femoral stem component has shown excellent results in early clinical studies. This is an independent prospective study of the...
1069
Authors: Dong Dong Wang, Wei Min Zhu, Lei Tan, Ming Li, Yuan Li Guo, Lei Feng Zhang, Dong Zhu
Chapter 3: General Mechanical Engineering
Abstract:Objective To compare the biomechanical properties of two lag screws proximal femoral nail(PFN) when they are placed in different points of...
875
Authors: Razvan Ene, Mihai Nica, Zsombor Panti, Marian Pleniceanu, Patricia Ene, Monica Cirstoiu, Iulian Vasile Antoniac, Catalin Cirstoiu
Chapter 2: Materials and Technologies in Orthopedic Surgery
Abstract:Ipsilateral proximal femur combined with diaphyseal fracture is a rare and problematic combination of injuries with serious potential...
106