Fixation of displaced femoral neck fractures: A comparison between sliding screw plate and four cancellous bone screws

Madsen, Frank; Linde, Frank; Andersen, Erik André; Birke, Hanne; Hvass, Inge; Poulsen, Torben Dam

doi:10.3109/17453678709146468

Cited by 106 publications

(58 citation statements)

References 29 publications

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“…It was also reported by Swiontkowski and Winquist [37] that use of cannulated screws for femoral neck fractures causes lower blood loss during operation. Madsen et al [38] reported that application of DHS for these fractures causes prolonged operation and more blood loss, which supports the results of our study. In our study, there was no difference between groups according to occurrence of AVN (p>0.05), and this complication was seen more in displaced fractures in both groups (p>0.05).…”

Section: Discussionsupporting

confidence: 83%

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Kaplan¹,

Akesen²,

Demirağ³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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Section: Discussionsupporting

confidence: 83%

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Kaplan¹,

Akesen²,

Demirağ³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…The results with the SGN compare favourably with those of previous reports on the SHS 3,4,[7][8][9]31 and are comparable with those previously reported with the MSP. 4,9-11 The main problem remains the risk of intra-operative fractures, 3/109 (2.75%) in our study, although, in most cases, they were induced by inappropriate surgical technique.…”

Section: Discussionsupporting

confidence: 82%

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

Miedel

Ponzer

Törnkvist

et al. 2005

The Journal of Bone and Joint Surgery. British volume

122

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We studied 217 patients with an unstable trochanteric or subtrochanteric fracture who had been randomly allocated to treatment by either internal fixation with a standard Gamma nail (SGN) or a Medoff sliding plate (MSP, biaxial dynamisation mode). Their mean age was 84 years (65 to 99) and they were reviewed at four and 12 months after surgery. Assessments of outcome included general complications, technical failures, revision surgery, activities of daily living (ADL), hip function (Charnley score) and the health-related quality of life (HRQOL, EQ-5D).The rate of technical failure in patients with unstable trochanteric fractures was 6.5% (6/ 93) (including intra-operative femoral fractures) in the SGN group and 5.2% (5/96) in the MSP group. In patients with subtrochanteric fractures, there were no failures in the SGN group (n = 16) and two in the MSP group (n = 12). In the SGN group, there were intraoperative femoral fractures in 2.8% (3/109) and no post-operative fractures. There was a reduced need for revision surgery in the SGN group compared with the MSP group (8.3%; 9/108; p = 0.072). The SGN group also showed a lower incidence of severe general complications (p < 0.05) and a trend towards a lower incidence of wound infections (p = 0.05). There were no differences between the groups regarding the outcome of ADL, hip function or the HRQOL. The reduction in the HRQOL (EQ-5D index score) was significant in both groups compared with that before the fracture (p < 0.005).Our findings indicate that the SGN showed good results in both trochanteric and subtrochanteric fractures. The limited number of intra-operative femoral fractures did not influence the outcome or the need for revision surgery. Moreover, the SGN group had a reduced number of serious general complications and wound infections compared with the MSP group. The MSP in the biaxial dynamisation mode had a low rate of failure in trochanteric fractures but an unacceptably high rate when used in the biaxial dynamisation mode in subtrochanteric fractures.The negative influence of an unstable trochanteric or subtrochanteric fracture on the quality of life was significant regardless of the surgical method.The treatment of stable trochanteric fractures of type 1 or type 2 according to the classification of Jensen and Michaelsen (J-M) 1 is uncontroversial and good results can be expected with various implants. 2 Most authors favour the sliding hip screw (SHS) and recent studies on this method have shown rates of failure below 2%. 3,4 In the case of unstable trochanteric fractures (J-M type 3 to 5) 1 and subtrochanteric fractures, 5 the treatment is more controversial and the rate of failure for the SHS in these fractures is considerably higher, ranging from 4% to 15%. 3,4,[6][7][8][9] The Medoff sliding plate (MSP) evolved from the SHS and gives axial compression along both the femoral neck (optional) and the femoral shaft. It has produced remarkably good results in prospective trials in both unstable trochanteric and subtrochanteric fractures with a rate of fa...

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“…Many studies have found small or no significant differences when comparing methods of internal fixation (Nordkild et al 1985, Svenningsen et al 1985, Paus et al 1986, Madsen et al 1987. Others have shown that the outcome can be influenced by the choice of the internal fixation device Andersen 198 1, Frandsen et al 1984, Svenningsen et al 1984).…”

Section: Internal Fixation Of 41 0 Cervical Hip Fractures a Randomizementioning

confidence: 99%

Internal fixation of 410 cervical hip fractures: A randomized comparison of a single nail versus two hook-pins

Sernbo

Johnell

Bååth

et al. 1990

Acta Orthopaedica Scandinavica

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Fixation of displaced femoral neck fractures: A comparison between sliding screw plate and four cancellous bone screws

Cited by 106 publications

References 29 publications

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures

Internal fixation of 410 cervical hip fractures: A randomized comparison of a single nail versus two hook-pins

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