Key result
The Medoff sliding plate significantly reduced the failure rate in unstable intertrochanteric fractures compared to a standard compression hip screw (3% vs 14%).
Why the study?
Does the Medoff sliding plate reduce failure rates compared to a standard compression hip screw in patients with intertrochanteric fractures?
RCT (n=160)
randomized
Does the Medoff sliding plate reduce failure rates compared to a standard compression hip screw in patients with intertrochanteric fractures?
Absolute Event Rate: 3% vs 14%
The Medoff sliding plate significantly reduces the failure rate in unstable intertrochanteric fractures compared to a standard compression hip screw, despite increased blood loss and operating time.
May reduce failure in unstable intertrochanteric fractures; leaves open need for confirmatory trials before practice change.
The Medoff sliding plate was designed to achieve compression along the femoral neck and the longitudinal axis of the femoral shaft theoretically to improve the treatment of intertrochanteric hip fractures. The Medoff sliding plate was compared with a standard compression hip screw in a randomized, prospective study for the fixation of 160 stable and unstable intertrochanteric fractures with an average followup of 9.5 months (range, 6-26 months). Overall, 91 fractures were treated using the compression hip screw and 69 were treated with the Medoff sliding plate. Stable fracture patterns (46) united without complication in both treatment groups. Unstable fractures (114) had an overall failure rate of 9.6%, 14% (nine patients) with the compression hip screw and 3% (two patients) with the Medoff plate; this difference was significantly different. The time to union for the 114 unstable fractures was not significantly different between the two devices. For all patients, no differences in lengths of hospitalization, return to ambulatory status before fracture, postoperative living status, or postoperative pain was observed between the two device groups. Use of the Medoff plate for all fracture types was associated with a significantly higher amount of blood loss and operating time.
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Watson et al. (1998) conducted an RCT in stable and unstable intertrochanteric fractures (n=160). Medoff sliding plate vs. standard compression hip screw was evaluated on failure rate in unstable fractures. The Medoff sliding plate significantly reduced the failure rate in unstable intertrochanteric fractures compared to a standard compression hip screw (3% vs 14%).