Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture

Zhang, Hua; Xu, Zhongwei; Zhou, Aiguo; Yan, Wenlong; Zhao, Peng; Huang, Xiao; Zhang, Jian

doi:10.1097/md.0000000000005614

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…While the double loop technique is one of the treatments most often described in the literature, various alternatives can be deployed for trochanteric fixation. Among these, trochanteric claw plates, the greater trochanter reattachment device (GTRD = claw plate + cables) [45], tension band wiring [46], or Ethibond suture fixation [47] have been described. However, these techniques have mostly been used in the context of greater trochanteric osteotomies or unstable intertrochanteric fractures rather than IPFs of the greater trochanter.…”

Section: Discussionmentioning

confidence: 99%

Risk analysis and clinical outcomes of intraoperative periprosthetic fractures: a retrospective study of 481 bipolar hemiarthroplasties

Bellova¹,

Baecker²,

Lotzien³

et al. 2019

J Orthop Surg Res

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Background: Intraoperative periprosthetic fractures (IPF) are a well-described complication following hip hemiarthroplasty. Our aims were to identify risk factors that characterize IPF and to investigate postoperative mobility. Methods: We retrospectively reviewed 481 bipolar hemiarthroplasties for displaced femoral neck fractures; of which, 421 (87.5%) were performed without cement, from January 2013 to March 2018. Data on the patients' demographics, comorbidities, femoral canal geometry (Dorr canal type, Canal Flare Index), surgeon's experience (junior vs. senior surgeon), and timing of surgery (daytime vs. on-call duty) were obtained. In patients with intraoperative fractures, further information was obtained. Patient mobility was assessed using matched-pair analysis. Mobility was classified according to the NHFD mobility score. The chi-square test, Fisher's exact test, and Fisher-Freeman-Halton exact test were used for comparison between categorical variables, while the Mann-Whitney U test was used for continuous variables. The data analysis was performed using SPSS. Results: Of 481 procedures, 34 (7.1%) IPFs were encountered. The Dorr canal type C was identified as a significant risk factor (p = .004). Other risk factors included female sex (OR 2.30, 95% CI .872-6.079), stovepipe femur (OR 1.749, 95% CI .823-3.713), junior surgeon (OR 1.204, 95% CI .596-2.432), and on-call-duty surgery (OR 1.471, 95% CI .711-3.046), although none showed a significant difference. Of 34 IPFs, 25 (73.5%) were classified as Vancouver type A. The treatment of choice was cerclage wiring. Within the 12 matched pairs identified, the postoperative mobility was slightly worse for the IPF group (delta = .41). Conclusions: IPF is a serious complication with bipolar hemiarthroplasty. The identification of risk factors preoperatively, in particular femur shape, is crucial and should be incorporated into the decision-making process.

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Section: Discussionmentioning

confidence: 99%

Risk analysis and clinical outcomes of intraoperative periprosthetic fractures: a retrospective study of 481 bipolar hemiarthroplasties

Bellova¹,

Baecker²,

Lotzien³

et al. 2019

J Orthop Surg Res

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show abstract

“…En un estudio que aplican la hemiartroplastía primaria para el tratamiento de fracturas femorales pertrocantéricas inestables (AO/OTA tipo 31 A2.3), en pacientes osteoporóticos mayores, se demuestra que la artroplastía es un procedimiento seguro y eficaz, mostrando una capacidad anterior para soportar el peso total del cuerpo, con una tasa de recuperación más rápida y una mejor calidad de vida (Waddell et al, 2004;Zhang et al).…”

Section: Discussionunclassified

“…Con la asociación de una banda de tensión, con cerclaje a la artroplastía, la cual debe insertarse de forma endomedular, se garantiza una mejor estabilidad protésica y mejora la propiocepcion del paciente, beneficiándose el postoperatorio para realizar ejercicios funcionales tempranos con cojinete de peso parcial (Sun et al;Zhang et al, 2017).…”

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Artroplastía Parcial de Cadera con Banda de Tensión en Fracturas de Fémur Proximal en Pacientes Ancianos

et al. 2019

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RESUMEN: Las fracturas intertrocantéricas en adulto mayor presentan gran dificultad para lograr una cicatrización ósea estable y una fijación en la artroplastía, para la recuperación completa y funcional del anciano. En pacientes adultos mayores sin stock óseo, se recomienda realizar anexo a la artroplastía de cadera, la colocación de una banda de tensión, con la finalidad de brindar mayor estabilidad a los fragmentos y sustentación a la artroplastía primaria, con el objetivo de lograr un retorno a la calidad de vida normal. A las cuatro semanas de la cirugía, se evidencia una mejora en la escala funcional alcanzando una puntuación media de 83, considerandose un buen resultado. En los controles subsecuentes se evidencia una media en la escala de Harris de 87. Los pacientes volvieron a su nivel de actividad preoperatoria, más de la mitad de los pacientes fueron capaces de caminar sin apoyos, y finalmente, no se reportaron complicaciones en los controles postquirúrgicos al seguimiento de un año.

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Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?

Lee¹,

Lee²,

Noh³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture

Abstract: Supplemental Digital Content is available in the text

Cited by 4 publications

References 27 publications

Risk analysis and clinical outcomes of intraoperative periprosthetic fractures: a retrospective study of 481 bipolar hemiarthroplasties

Risk analysis and clinical outcomes of intraoperative periprosthetic fractures: a retrospective study of 481 bipolar hemiarthroplasties

Artroplastía Parcial de Cadera con Banda de Tensión en Fracturas de Fémur Proximal en Pacientes Ancianos

Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?

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