Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fractures

Giancola, R; Antonini, Guido; Rose, Giacomo Delle; Crippa, Cornelio

doi:10.1007/s11751-008-0032-1

Cited by 14 publications

(5 citation statements)

References 17 publications

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“…Kosygan et al [ 27 ] found that the operation time, particularly during the learning period, is longer in the PCCP group than that in the DHS group and believed that learning curve is more demanding for PCCP when compared with the relative simplicity of the DHS. On the contrary, some studies [ 23 , 40 , 41 ] have reported a shorter operative time and almost no learning curve with this new device when placed by both senior surgeons and residents.…”

Section: Discussionmentioning

confidence: 96%

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: Discussionmentioning

confidence: 96%

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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“…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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“…The PCCP has been successfully used for the treatment of intertrochanteric fractures of the hip in previous clinical studies. [4][5][6][7][8] The objective of this radiographic study was to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a PCCP using identical meticulous closed reduction techniques in both groups.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Lateral Trochanteric Wall Fractures: Sliding Hip Screw versus Percutaneous Compression Plate for Intertrochanteric Hip Fractures

Langford

Pillai²,

Ugliailoro³

et al. 2011

Journal of Orthopaedic Trauma

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Overall, the PCCP group had a significantly decreased incidence of lateral trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.

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Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fractures

Cited by 14 publications

References 17 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

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

Perioperative Lateral Trochanteric Wall Fractures: Sliding Hip Screw versus Percutaneous Compression Plate for Intertrochanteric Hip Fractures

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