Does operative treatment by AO dynamic hip-screw improve outcomes compared to traction in elderly patients with extracapsular hip fractures?
Operative treatment with a dynamic hip-screw for elderly patients with extracapsular hip fractures reduces hospital stay and preserves independence better than conservative traction.
All elderly patients with extracapsular hip fractures seen in hospitals in Newcastle upon Tyne over a 12-month period were studied and followed up for six months. At one of the hospitals, patients were randomised to treatment by AO dynamic hip-screw or by traction. Complications specific to the two treatments were low, and general complications, six-month mortality and prevalence of pain, leg swelling and unhealed sores, showed no difference between the two modes of treatment. Operative treatment gave better anatomical results and a shorter hospital stay, but significantly more of the patients treated by traction showed loss of independence six months after injury.
Hornby et al. (Tue,) studied this question.