Standards in der Versorgung proximaler Femurfrakturen

Jaeschke-Melli, S.; Hedke, Jörg; Meiners, J.; Dannenberg, O.; Jürgens, Ch.; Faschingbauer, M.

doi:10.1007/s10039-013-1963-4

Cited by 1 publication

(1 citation statement)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In primary care, extramedullary implants such as the dynamic hip screw (DHS) are increasingly less important. In up to 20% of trochanteric and subtrochanteric fractures, there is no osseous healing, and thus, the symptomatic nonunion is associated with significant limitations and pain for those patients affected [ 1 ]. Potential causes for nonunion development are usually related to improperly respected biomechanics, initial implant placement or implant selection, excessive remaining bony gaps in the fracture area or infection [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Functional and Radiological Results Following Revision Blade Plating and Cephalomedullary Nailing in Aseptic Trochanteric and Subtrochanteric Nonunion

Rehme-Röhrl,

Brand,

Dolt

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Trochanteric and subtrochanteric fractures result in nonunion in more than 20% of cases. The aim of this study was to assess the functional and radiological results following revision cephalomedullary nailing and 95-degree angled blade plating in aseptic trochanteric and subtrochanteric nonunion. Methods: In a retrospective multi-center study between January 2010 and December 2020, a total of 68 consecutive patients (21 women and 47 men) from two European level I trauma centers with the diagnosis of aseptic nonunion were recruited. Follow-up assessment and the patients’ convenience were assessed using the Harris Hip Score, Visual Analog Scale for pain at rest and on stress/exertion and Short Form-12. Results: The patients’ mean age was 57 (range 26–85) years. After a follow-up period of 12 months, one case of persistent nonunion in the cephalomedullary nail group and 10 cases in the blade plate group were identified. The mean duration of surgery was 137 ± 47 min in the cephalomedullary nail group and 202 ± 59 min in the blade plate group (<0.0001). Short-term postoperative complications included wound dehiscence, bleeding, mismatched screw and hematoma. The mid-term results 12 months after surgical revision demonstrated significantly different osseous union rates (p = 0.018). The long-term functional outcome according to the Harris Hip Score 6 years (range 2–10) after revision surgery demonstrated 81 ± 21 points in the cephalomedullary nail group and 64 ± 23 points in the plate group (p = 0.026). Conclusions: This study demonstrated that the revision treatment of trochanteric and subtrochanteric nonunion using a 95-degree blade plate or cephalomedullary nail resulted in a high percentage of osseous union, with a low incidence of complications and good functional results for both methods.

show abstract

Section: Introductionmentioning

confidence: 99%