Extramedullary fixation implants and external fixators for extracapsular hip fractures

Parker, Martyn J.; Handoll, Helen

doi:10.1002/14651858.cd000339

Cited by 16 publications

(21 citation statements)

References 22 publications

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“…4 A number of studies have reported the use of external fixation in the management of trochanteric fracture of the femur, but only a few were comparative trials providing evidence of less operative trauma and speedier recovery for external fixation, when compared with the sliding hip screw. 3,5,6 If external fixation is to be widely accepted as an effective alternative to the sliding hip screw in the management of trochanteric fractures, a randomised controlled trial is required to compare efficacy with cost. This was the aim of our study.…”

mentioning

confidence: 99%

Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal

Karn

Singh

Kumar

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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We conducted a randomised controlled trial to compare external fixation of trochanteric fractures of the femur with the more costly option of the sliding hip screw. Patients in both groups were matched for age (mean 67 years, 50 to 100) and gender. We excluded all pathological fractures, patients presenting at more than one week, fractures with subtrochanteric extension or reverse obliquity, multiple fractures or any bone and joint disease interfering with rehabilitation. The interval between injury and operation, the duration of surgery, the amount of blood loss, the length of hospital stay and the cost of treatment were all significantly higher in the sliding hip screw group (p < 0.05). The time to union, range of movement, mean Harris hip scores and Western Ontario and McMaster University knee scores were comparable at six months. The number of patients showing shortening or malrotation was too small to show a significant difference between the groups. Pin-track infection occurred in 18 patients (60%) treated with external fixation, whereas there was a single case of wound infection (3.3%) in the sliding hip screw group.

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confidence: 99%

Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal

Karn

Singh

Kumar

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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“…We feel this plate may be too short, especially for unstable trochanteric fractures. Gotfried described an alternative hip screw fixation system using a percutaneous locking plate, which is still under evaluation but which may reduce pain and intraoperative blood loss (8)(9)(10). A comparative study of minimally-invasive SHS insertion against an approach with a more extensive exposure would be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Sliding Hip Screw Insertion Technique

Khan

Parker

2012

HIP International

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Sliding hip screws (SHS) are commonly used for fixation of extra-capsular hip fractures, and there is increasing use of minimally invasive methods of insertion of such devices. We describe a case series of 579 consecutive patients operated on by the senior author using such a technique. Data were collected prospectively and analysed retrospectively. The technique involves a 5cm incision, retraction of vastus lateralis superiorly by a chain retractor, and use of a SHS clamp to stabilise the plate on the femur. The patients had a mean age of 81 years, surgery time of 43 minutes and hospital stay of 17 days. 77% were female and 35% required a blood transfusion post-operatively. Everyone was mobilised fully weight-bearing post-operatively. Follow-up was at six weeks for radiographic review and then subsequently at one year. The commonest complications were superficial wound infection (1.7%), detachment of the plate (0.9%) and cut-out of the lag screw (0.5%).

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“…We found one systematic review (search date 1998) 13. Three RCTs compared a fixed nail plate (Jewett or McLaughlin) against the sliding hip screw.…”

Section: Methodsmentioning

confidence: 99%

Extracts from "Clinical Evidence": Hip fracture

Gillespie

2001

BMJ

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Extramedullary fixation implants and external fixators for extracapsular hip fractures

Cited by 16 publications

References 22 publications

Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal

Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal

Minimally Invasive Sliding Hip Screw Insertion Technique

Extracts from "Clinical Evidence": Hip fracture

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