Minimally invasive osteosynthesis in stable trochanteric fractures: a comparative study between Gotfried percutaneous compression plate and Gamma 3 intramedullary nail

Varela-Egocheaga, J.R.; Iglesias-Colao, R.; Suárez-Suárez, M.A.; Fernández-Villán, M.; González-Sastre, V.; Murcia-Mazón, A.

doi:10.1007/s00402-009-0955-0

Cited by 49 publications

(27 citation statements)

References 23 publications

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“…Failure rates will vary, however, depending on the stability of the fracture type. While most studies included both stable and unstable fracture patterns, Varela-Egocheaga [6] solely focused on stable fracture types noting a failure rate of 3.8%; this can be contrasted with the findings of Sadowski et al [7] who investigated only the most unstable fracture patterns (reverse oblique and transverse intertrochanteric) and noted a significant increase in failure rate to 22.9%. …”

Section: Resultsmentioning

confidence: 99%

Osteoporotic Hip Fractures: The Burden of Fixation Failure

Broderick

Bruce-Brand

Stanley

et al. 2013

The Scientific World Journal

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Osteoporotic hip fractures are a major cause of morbidity and mortality in the elderly. Furthermore, reduced implant anchorage in osteoporotic bone predisposes towards fixation failure and with an ageing population, even low failure rates represent a significant challenge to healthcare systems. Fixation failure in fragility fractures of the hip ranges from 5% in peritrochanteric fractures through to 15% and 41% in undisplaced and displaced fractures of the femoral neck, respectively. Our findings, in general, support the view that failed internal fixation of these fragility fractures carries a poor prognosis: it leads to a twofold increase in the length of hospital stay and a doubling of healthcare costs. Patients are more likely to suffer a downgrade in their residential status upon discharge with a consequent increase in social dependency. Furthermore, the marked disability and reduction in quality of life evident before salvage procedures may persist at long-term followup. The risk, of course, for the elderly patient with a prolonged period of decreased functioning is that the disability becomes permanent. Despite this, however, no clear link between revision surgery and an increase in mortality has been demonstrated in the literature.

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Section: Resultsmentioning

confidence: 99%

Osteoporotic Hip Fractures: The Burden of Fixation Failure

Broderick

Bruce-Brand

Stanley

et al. 2013

The Scientific World Journal

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“…The literature comparing blood loss in intertrochanteric hip fractures treated with intramedullary nail or DHS is inconclusive. Authors have reported reduced blood loss, [25][26][27] increased blood loss 28 and no difference 29,30 in patients with intertrochanteric fractures treated with an intramedullary nail. The variability among studies may be related to differences in fracture severity, as patients with more displaced fractures are generally more likely to be treated with an intramedullary device.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

et al. 2014

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Background: Hip fractures are common injuries that result in blood loss and frequently require the transfusion of blood products. We sought to identify risk factors leading to increased blood transfusion in patients presenting with hip fractures, especially those factors that are modifiable. Methods:We retrospectively reviewed the cases of all patients who had fixation of their hip fractures between October 2005 and February 2010. The need for transfusion was correlated with potential risk factors, including age, sex, preoperative hemoglobin, fracture type, fixation method and more.Results: A total of 835 patients had fixation of their hip fractures during the study period; 631 met the inclusion criteria and 249 of them (39.5%) were transfused. We found an association between need for blood transfusion and female sex (p = 0.018), lower preoperative hemoglobin (p < 0.001), fracture type (p < 0.001) and fixation method (p < 0.001). Compared with femoral neck fractures, there was a 2.37 times greater risk of blood transfusion in patients with intertrochanteric fractures (p < 0.001) and a 4.03 times greater risk in those with subtrochanteric fractures (p < 0.001). Dynamic hip screw (DHS) fixation decreased the risk of transfusion by about half compared with intramedullary nail or hemiarthroplasty. We found no association with age, delay to operation (p = 0.17) or duration of surgery (p = 0.30). Conclusion:The only modifiable risk factor identified was fixation method. When considering blood transfusion requirements in isolation, we suggest a potential benefit in using a DHS for intertrochanteric and femoral neck fractures amenable to DHS fixation.Contexte : La fracture de la hanche est un traumatisme fréquent, qui cause une perte sanguine et nécessite souvent la transfusion de produits sanguins. Nous avons tenté d'identifier les facteurs de risque associés à une hausse du nombre des transfusions sanguines chez des patients ayant subi une fracture de la hanche, en particulier les facteurs modifiables.Méthodes : Au cours d'une étude rétrospective, on a revu les cas de tous les patients chez qui on avait pratiqué une ostéosynthèse pour une fracture de la hanche survenue entre octobre 2005 et février 2010. La nécessité d'une transfusion sanguine a été associée à d'éventuels facteurs de risque, dont l'âge, le sexe, le taux d'hémoglobine préopéra-toire, le type de fracture, la technique d'ostéosynthèse, et d'autres facteurs encore.Résultats : Au total, 835 patients avaient subi une ostéosynthèse pour fracture de la hanche au cours de la période à l'étude; 631 satisfaisaient les critères d'inclusion à l'étude et parmi eux, 249 (39,5 %) ont reçu une transfusion sanguine. On a observé l'existence d'un lien entre la nécessité d'une transfusion sanguine et le sexe féminin (p = 0,018), une plus faible concentration d'hémoglobine préopératoire (p < 0,001), le type de fracture (p < 0,001) et la technique d'ostéosynthèse (p < 0,001). Par rapport aux fractures du col fémoral, le risque de transfusion sanguine était 2,37 fois plus é...

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“…1,2 In stable trochanteric fractures, complication rates of 0%-4% are reported. 3,4 Particularly, varus collapse and cutout of the lag screw pose daunting problems to the surgeon and remain amongst the main causes of treatment failure. 5,6 Inherently unstable fracture patterns in mainly osteoporotic bone in conjunction with the quality of the reduction and screw positioning in the femoral headneck fragment predispose to many complications, including implant cutout.…”

Section: Introductionmentioning

confidence: 99%

Rotationally Stable Screw-Anchor Versus Sliding Hip Screw Plate Systems in Stable Trochanteric Femur Fractures

Knobe¹,

Gradl

Maier

et al. 2013

Journal of Orthopaedic Trauma

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The fixation of stable trochanteric femur fractures with RoSA in cadavers led to greater primary stability under cyclic load, with significant advantages with regard to stiffness, failure load, and rotational stability, compared with the SHS. A detrimental effect was its migration tendency, which began at 1800 N and occurred in the cranial direction. A meticulous insertion technique was a prerequisite to avoid iatrogenic perforation of the femoral head. Our results will have to be substantiated by further biomechanical and clinical trials using an optimized RoSA system.

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Minimally invasive osteosynthesis in stable trochanteric fractures: a comparative study between Gotfried percutaneous compression plate and Gamma 3 intramedullary nail

Abstract: PCCP and Gamma 3 have not presented significant differences in any measured parameter for treatment of stable trochanteric fractures. Therefore, the PCCP system is shown to be as minimally invasive as the Gamma 3.

Cited by 49 publications

References 23 publications

Osteoporotic Hip Fractures: The Burden of Fixation Failure

Osteoporotic Hip Fractures: The Burden of Fixation Failure

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

Rotationally Stable Screw-Anchor Versus Sliding Hip Screw Plate Systems in Stable Trochanteric Femur Fractures

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