What is the clinical evidence from this study?

Study design: RCT. Population: unstable intertrochanteric fractures (n=127). Intervention: anatomical reduction vs. medial displacement osteotomy. Primary outcome: walking ability, social status or failure of fixation.

What does this research mean for the field?

In unstable intertrochanteric femur fractures treated with sliding hip screws, anatomical reduction yields clinical outcomes and fixation failure rates comparable to medial displacement osteotomy, but with significantly lower operative time and blood loss. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 1, 1993Journal of Bone and Joint Surgery - British Volume

Unstable intertrochanteric fracture of the femur. A prospective randomised study comparing anatomical reduction and medial displacement osteotomy

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Key result

Anatomical reduction matches medial displacement osteotomy for primary outcomes but reduces operating time and blood loss.

n=127

Why the study?

Does medial displacement osteotomy improve outcomes compared to anatomical reduction in patients with unstable intertrochanteric fractures?

Population

127 consecutive patients with unstable intertrochanteric fractures

Comparison

Medial displacement osteotomy vs Anatomical reduction

Design

RCT, randomised

Follow-up

average 11 months

Authors

ADA. L. DesjardinsUniversité de Montréal ARAudrey RoyCentre for Interdisciplinary Research in Rehabilitation GPGuy D. PaiementCedars-Sinai Medical Center

Discussion

Member takes

Implication

Favors anatomical reduction over medial displacement osteotomy for unstable intertrochanteric fractures; challenges routine use of osteotomy.

Study Design

Type

RCT (n=127)

Randomization

randomised

Structured PICO

Does medial displacement osteotomy improve outcomes compared to anatomical reduction in patients with unstable intertrochanteric fractures?

Population

127 consecutive patients with unstable intertrochanteric fractures, followed for an average of 11 months.

Intervention

Medial displacement osteotomy

Comparator

Anatomical reduction

Outcome

Walking ability, social status, failure of fixation, postoperative complication rates, early mortality rate, operating time, and blood loss

Medial displacement osteotomy offers no clinical advantage over anatomical reduction for unstable intertrochanteric fractures and is associated with increased operating time and blood loss.

Cite This Study

Desjardins et al. (1993) conducted an RCT in unstable intertrochanteric fractures (n=127). anatomical reduction vs. medial displacement osteotomy was evaluated on walking ability, social status or failure of fixation. Anatomical reduction yielded similar walking ability, social status, and fixation failure compared to medial displacement osteotomy, which had significantly higher operating time and blood loss.

synapsesocial.com/papers/6aa63067246eab12a27f42e1 https://doi.org/10.1302/0301-620x.75b3.8496218

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Implication

Favors anatomical reduction over medial displacement osteotomy for unstable intertrochanteric fractures; challenges routine use of osteotomy.

Unstable intertrochanteric fracture of the femur. A prospective randomised study comparing anatomical reduction and medial displacement osteotomy

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Unstable intertrochanteric fracture of the femur. A prospective randomised study comparing anatomical reduction and medial displacement osteotomy

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider