OBJECTIVES: The aim of this study was to compare the long-term results of two groups of patients with trochanteric fractures of the femur treated with eitherdynamic hip screw (DHS) or AO angled blade plate (AP) insertions. METHODS: A total of 157 patients with trochanteric fractures were included in the study, and 82 patients underwentdynamic hip screw insertion, and 75 underwent AO angled blade plate insertion. The mean follow-up period was 8 years (range 2.3-11.7 years) in the DHS group, and 8.5 years (2.4-12.5 years) in the AP group. RESULTS: According to the Boyd and Griffin classification, there were 37 stable fractures (45%) and 45 unstable fractures (55%) in the DHS group, whereas there were 42 stable fractures (56%) and 33 unstable fractures (44%) in the AP group. According to Clawson's functional classification, 64% of patients in the AP group and 81% in the DHS group had good or excellent function (p<0.05). Similarly, according to Foster's classification, 68% of patients in the AP group, and 85% in the DHS group had good to excellent results (p<0.05). CONCLUSION: DHS yields better long-term results in trochanteric fractures than do AO angled blade plates by providing earlier mobilization of the patient, better stability, and earlier union.
RCT Entities:
OBJECTIVES: The aim of this study was to compare the long-term results of two groups of patients with trochanteric fractures of the femur treated with either dynamic hip screw (DHS) or AO angled blade plate (AP) insertions. METHODS: A total of 157 patients with trochanteric fractures were included in the study, and 82 patients underwent dynamic hip screw insertion, and 75 underwent AO angled blade plate insertion. The mean follow-up period was 8 years (range 2.3-11.7 years) in the DHS group, and 8.5 years (2.4-12.5 years) in the AP group. RESULTS: According to the Boyd and Griffin classification, there were 37 stable fractures (45%) and 45 unstable fractures (55%) in the DHS group, whereas there were 42 stable fractures (56%) and 33 unstable fractures (44%) in the AP group. According to Clawson's functional classification, 64% of patients in the AP group and 81% in the DHS group had good or excellent function (p<0.05). Similarly, according to Foster's classification, 68% of patients in the AP group, and 85% in the DHS group had good to excellent results (p<0.05). CONCLUSION:DHS yields better long-term results in trochanteric fractures than do AO angled blade plates by providing earlier mobilization of the patient, better stability, and earlier union.
Authors: Sharon R Lewis; Richard Macey; Joseph Lewis; Jamie Stokes; James R Gill; Jonathan A Cook; William Gp Eardley; Martyn J Parker; Xavier L Griffin Journal: Cochrane Database Syst Rev Date: 2022-02-10