E Crespo1, J Galvez2, J M Tenías2, I Cano2, R Crespo2, V Palacios2. 1. Hospital Mancha-Centro, Avenida de la Constitución s/n, C/Coscoja no. 3, Alcázar de San Juan, 13600, Ciudad Real, Spain. ecresporomero@gmail.com. 2. Hospital Mancha-Centro, Avenida de la Constitución s/n, C/Coscoja no. 3, Alcázar de San Juan, 13600, Ciudad Real, Spain.
Abstract
PURPOSE: Nowadays, the literature shows better results in the treatment of intertrochanteric (AO/OTA 31.A1-A2) hip fractures with dynamic hip screw (DHS) compared with gamma nail (GN). Besides, percutaneous compression plate (PCCP) gives results which are better or similar to those obtained with DHS. But only two reports compare the results between PCCP and GN. The aim of this trial is to compare the outcome of treatment of these fractures with either a PCCP or a GN. METHODS: A retrospective trial with 414 patients over 60 years of age treated in our institution for 6 years, with a minimum follow-up of 1 year, was performed to compare the outcome of a PCCP (240) with a GN (174). RESULTS: The post-operative hospital stay was 2 days longer in the GN group compared to the PCCP group (p < 0.001). The post-operative haemoglobin serum level was slightly lower in the GN group (relative risk (RR) -0.28, 95% confidence interval (CI): -0.02 to -0.54, p = 0.036) and the transfusion requirement was lower in the PCCP group (GN 53.4% vs. PCCP 33.8%, p < 0.001). The procedure-related complications rate was higher in the GN group (9.8 vs. 5%, p = 0.06). CONCLUSIONS: PCCP has lower overall economical cost and blood transfusional requirements for a similar or better outcome in terms of procedure-related complications.
PURPOSE: Nowadays, the literature shows better results in the treatment of intertrochanteric (AO/OTA 31.A1-A2) hip fractures with dynamic hip screw (DHS) compared with gamma nail (GN). Besides, percutaneous compression plate (PCCP) gives results which are better or similar to those obtained with DHS. But only two reports compare the results between PCCP and GN. The aim of this trial is to compare the outcome of treatment of these fractures with either a PCCP or a GN. METHODS: A retrospective trial with 414 patients over 60 years of age treated in our institution for 6 years, with a minimum follow-up of 1 year, was performed to compare the outcome of a PCCP (240) with a GN (174). RESULTS: The post-operative hospital stay was 2 days longer in the GN group compared to the PCCP group (p < 0.001). The post-operative haemoglobin serum level was slightly lower in the GN group (relative risk (RR) -0.28, 95% confidence interval (CI): -0.02 to -0.54, p = 0.036) and the transfusion requirement was lower in the PCCP group (GN 53.4% vs. PCCP 33.8%, p < 0.001). The procedure-related complications rate was higher in the GN group (9.8 vs. 5%, p = 0.06). CONCLUSIONS:PCCP has lower overall economical cost and blood transfusional requirements for a similar or better outcome in terms of procedure-related complications.
Entities:
Keywords:
Fracture fixation; Gamma nail; Hip fracture; Intertrochanteric fractures; Percutaneous compression plate; Percutaneous surgery
Authors: Heinrich M J Janzing; Bert J J Houben; Sven E Brandt; Vuthy Chhoeurn; Samuel Lefever; Paul Broos; Peter Reynders; Paul Vanderschot Journal: J Trauma Date: 2002-02