Whatʼs New in Orthopaedic Trauma

Cole, Peter A.; Bhandari, Mohit

doi:10.2106/jbjs.e.01068

Cited by 9 publications

(6 citation statements)

References 59 publications

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“…Approximately 50% of hip fractures occur in the intertrochanteric region [ 7 ]. To return to preinjury function and activity levels, early operative interventions have gradually become the preferred solution for the treatment of senile femoral intertrochanteric fracture [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Zhang

Shen

et al. 2014

The Scientific World Journal

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Background. Percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for the treatment of intertrochanteric fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus dynamic hip screw (DHS) fixation for intertrochanteric fractures. Methods. All randomized controlled trials (RCT) that compared PCCP with DHS in treating adult patients with intertrochanteric fractures were included. Main outcomes were collected and analysed using the RevMan 5.1 version. Results. Five trials met the inclusion criteria. Compared with DHS, PCCP had similar operation time (95% CI: −26.01~4.05, P = 0.15), length of hospitalization (95% CI: −1.79~1.25, P = 0.73), mortality (95% CI: 0.37~1.02, P = 0.06), incidence of implant-related complications (95% CI: 0.29~1.82, P = 0.49), and reoperation rate (95% CI: 0.41~3.05, P = 0.83). But blood loss (95% CI: −173.84~−4.81, P = 0.04) and transfusion need (95% CI: −0.53~−0.07, P = 0.01) significantly favored the PCCP. Conclusions. The PCCP was associated with reduced blood loss and less transfusion need, but similar to DHS in other respects. Owing to the limitations of this systematic review, more high-quality RCTs are still needed to assess the clinical efficiency of PCCP.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Zhang

Shen

et al. 2014

The Scientific World Journal

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“…Operative fixation techniques have overcome traditional conservative management, because early operative management will reduce the period of immobilization and provide early recovery. 1 However, correct patient selection and timely operation is the key for successful outcome. It is now agreed that the treatment principle of inter-trochanteric femur fractures among pre-injury ambulatory patients include rigid internal fixation and early postoperative physical activity.…”

Section: Discussionmentioning

confidence: 99%

“…Several techniques and implants have been described over the years, yet only few have yielded entirely satisfactory outcomes. 1,2 Dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) are the two most commonly used fixation devices for intertrochanteric fracture of femur.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Hip Screw (DHS) versus Proximal Femoral Nail Anti-rotation (PFNA) Fixation for Unstable (Evans-Jensen II and III) Inter-trochanteric Fractures of Femur in Elderly

Kandel

Shrestha

Poudel

et al. 2019

J Coll Med Sci-Nepal

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Background: Dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) are the two most commonly used fixation devices for inter-trochanteric fracture of femur. However, many clinical studies have shown lack of differences in the clinical outcome consistently with between these two fixation techniques. The main objective of this study is to compare the results of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) fixation in elderly patients with unstable inter-trochanteric fractures of femur. Methods: We retrospectively reviewed patients who underwent operative management for inter- trochanteric fractures of femur in our hospital between February 2013 and September 2017. Elderly patients (Age >60yrs) with unstable inter-trochanteric fracture of femur treated either with DHS fixation or with PFNA fixation were included and divided into two groups: DHS fixation group and PFNA fixation group. The comparative statistical analysis was done between two group using following parameters: average length of the incision, operation time, blood loss, fracture healing time, and degree of postoperative functional recovery. Results: The mean follow-up period, in DHS fixation group was 16 month (range 12 to 24 months) and in PFNA fixation group was 14 months (range 12 to 18 months). The differences between two groups regarding average length of the incision, operation time, and blood loss were statistically significant (p<0.05) and better in PFNA group whereas the differences between two groups regarding fracture healing time and the degree of postoperative functional recovery were not statistically significant (p >0.05). Conclusions: PFNA fixation may be better than DHS fixation for the treatment of unstable inter-trochanteric fractures of the femur in the elderly. However, the application and usage of DHS fixation could not be neglected and the choice of treatment depends upon the systemic condition and socioeconomic status of the patient, patient’s preferences, surgeon’s experience and availability of treatment facility.

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“…Before the introduction of suitable fixation devices, treatment of intertrochanteric fracture was non operative, consisting of prolonged bed rest in traction until fracture union (10-12 weeks). 4,5 This is followed by a lengthy programme of walking training. In elderly people, this was associated with high complication rates.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of unstable intertrochanteric fractures managed with proximal femoral nail: a prospective analysis

2018

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Background: Hip fractures are a growing concern for the orthopedic surgeons all over the world because the incidence of hip fractures is increasing dramatically and these fractures impose a significant challenge in their efficient management. The aim of the study was to prospectively analyze the functional outcome of unstable intertrochanteric fractures managed with ‘proximal femoral nail’.Methods: In our institution, we have selected 24 cases of unstable intertrochanteric fractures for this prospective study. All cases enrolled were managed with the proximal femoral nail. These cases were studied from the mechanism of injury, classification, and treatment with the proximal femoral nail and their surgical and functional outcome with or without residual comp.Results: Patients were followed up for an average period of 8.58 months. The mean Harris hip score was 88.75 at 6th month. The score was excellent in 12 patients, good in 10 patients, fair in 1 patient and poor in 1 patient. In our study of 24 patients with unstable intertrochanteric fracture, the average age incidence was 54.64 years. In the present study male: female was 5:3.Conclusions: In unstable proximal femur fractures, PFN is a significant advancement in the treatment of unstable trochanteric fractures which has the unique advantages of closed reduction, preservation of fracture hematoma, less tissue damage, early rehabilitation and early return to work.

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Whatʼs New in Orthopaedic Trauma

Cited by 9 publications

References 59 publications

Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

Dynamic Hip Screw (DHS) versus Proximal Femoral Nail Anti-rotation (PFNA) Fixation for Unstable (Evans-Jensen II and III) Inter-trochanteric Fractures of Femur in Elderly

Functional outcome of unstable intertrochanteric fractures managed with proximal femoral nail: a prospective analysis

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