Key result
Osteosynthesis with a percutaneous compression plate yielded equally satisfactory outcomes in stable and unstable intertrochanteric fractures, though unstable fractures had more pain (P=0.009).
Why the study?
Does osteosynthesis with a percutaneous compression plate yield different outcomes in unstable compared to stable intertrochanteric hip fractures in elderly patients?
Cohort (n=657)
No
Does osteosynthesis with a percutaneous compression plate yield different outcomes in unstable compared to stable intertrochanteric hip fractures in elderly patients?
Osteosynthesis with PCCP provides satisfactory outcomes in both stable and unstable intertrochanteric fractures, though stable fractures are associated with less pain and earlier walking ability.
Objectives: To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures. Design: Clinical prospective nonrandomized cohort study. Setting: San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital. Patients: Patients older than 65 years undergoing surgery for an intertrochanteric hip fracture (n = 657) were divided according to the OTA/AO classification, into stable (31-A1) (group A, n = 363) and unstable fractures (31-A2) (group B, n = 294). Intervention: Osteosynthesis with a PCCP (Orthofix Inc). Main Outcome Measurements: Blood loss, wound complications, postoperative pain, operative and fluoroscopy time, functional outcomes, device-related complications, consolidation time, and mortality. Results: Patients with unstable fractures were significantly worse with respect to postoperative pain, immediately (P = 0.020), at 6 weeks (P = 0.0001), and at 3 months (P = 0.009), and with respect to independent walking ability at 6 weeks. No other significant differences were observed. Conclusions: The outcomes of osteosynthesis with PCCP seem to be equally satisfactory in stable and unstable intertrochanteric fractures, with stable fractures having less pain and a greater ability to walk earlier. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Carvajal-Pedrosa et al. (2016) conducted a cohort in Intertrochanteric hip fracture (n=657). Unstable intertrochanteric fractures vs. Stable intertrochanteric fractures was evaluated on Blood loss, wound complications, postoperative pain, operative and fluoroscopy time, functional outcomes, device-related complications, consolidation time, and mortality. Osteosynthesis with a percutaneous compression plate yielded equally satisfactory outcomes in stable and unstable intertrochanteric fractures, though unstable fractures had more pain (P=0.009).
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