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European Journal of Trauma and Emergency Surgery

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01-08-2012 | Original Article

A comparative study between gamma nail and percutaneous compression plating for the treatment of intertrochanteric hip fractures

Authors: E. Crespo, J. Galvez, J. M. Tenías, I. Cano, R. Crespo, V. Palacios

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2012

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.

Schumpelick W, Jantzen PM. A new principle in the operative treatment of trochanteric fractures of the femur. J Bone Joint Surg Am. 1955;37:693–8.PubMed

Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instr Course Lect. 2004;53:441–54.PubMed

Liu M, Yang Z, Pei F, Huang F, Chen S, Xiang Z. A meta-analysis of the Gamma nail and dynamic hip screw in treating peritrochanteric fractures. Int Orthop. 2010;34(3):323–8.PubMedCrossRef

Verettas DA, Ifantidis P, Chatzipapas CN, Drosos GI, Xarchas KC, Chloropoulou P, Kazakos KI, Trypsianis G, Ververidis A. Systematic effects of surgical treatment of hip fractures: gliding screw-plating vs intramedullary nailing. Injury. 2010;41(3):279–84.PubMedCrossRef

Halder SC. The Gamma nail for peritrochanteric fractures. J Bone Joint Surg Br. 1992;74:340–4.PubMed

Anglen JO, Weinstein JN; American Board of Orthopaedic Surgery Research Committee. Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database. J Bone Joint Surg Am. 2008;90:700–7.PubMedCrossRef

Barton TM, Gleeson R, Topliss C, Greenwood R, Harries WJ, Chesser TJS. A comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31–A2 fractures of the proximal part of the femur: a prospective randomized trial. J Bone Joint Surg Am. 2010;92(4):792–8.PubMedCrossRef

Gotfried Y. Percutaneous compression plating of intertrochanteric hip fractures. J Orthop Trauma. 2000;14:490–5.PubMedCrossRef

Peyser A, Weil YA, Brocke L, Sela Y, Mosheiff R, Mattan Y, Manor O, Liebergall M. A prospective, randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip. J Bone Joint Surg Br. 2007;89:1210–7.PubMedCrossRef

10.

Panesar SS, Mirza S, Bharadwaj G, Woolf V, Ravikumar R, Athanasiou T. The percutaneous compression plate versus the dynamic hip screw: a meta-analysis. Acta Orthop Belg. 2008;74(1):38–48.PubMed

11.

Knobe M, Münker R, Schmidt-Rohlfing B, Sellei RM, Schubert H, Erli HJ. Surgical outcome in pertrochanteric femur fracture: the impact of osteoporosis. Comparison between DHS and percutaneous compression plate. Z Orthop Unfall. 2008;146(1):44–51.PubMedCrossRef

12.

Janzing HM, Houben BJ, Brandt SE, Chhoeurn V, Lefever S, Broos P, Reynders P, Vanderschot P. The gotfried perCutaneous compression plate versus the dynamic hip screw in the treatment of pertrochanteric hip fractures: minimal invasive treatment reduces operative time and postoperative pain. J Trauma. 2002;52(2):293–8.PubMedCrossRef

13.

Giancola R, Antonini G, Delle Rose G, Crippa C. Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fractures. Strategies Trauma Limb Reconstr. 2008;3:9–14.PubMedCrossRef

14.

Varela-Egocheaga JR, Iglesias-Colao R, Suárez-Suárez MA, Fernández-Villán M, González-Sastre V, Murcia-Mazón A. Minimally invasive osteosynthesis in stable trochanteric fractures: a comparative study between Gotfried percutaneous compression plate and Gamma 3 intramedullary nail. Arch Orthop Trauma Surg. 2009;129:1401–7.PubMedCrossRef

15.

Helwig P, Faust G, Hindenlang U, Hirschmüller A, Konstantinidis L, Bahrs C, Südkamp N, Schneider R. Finite element analysis of four different implants inserted in different positions to stabilize an idealized trochanteric femoral fracture. Injury. 2009;40(3):288–95.PubMedCrossRef

16.

Parker MJ, Handoll HH. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2008;3:CD000093.PubMed

17.

Laufer Y, Lahav M, Lenger R, Sprecher E. Functional recovery following pertrochanteric hip fractures fixated with the dynamic hip screw vs. the percutaneous compression plate. ScientificWorldJournal. 2005;19(5):221–9.CrossRef

18.

Bensafi H, Laffosse JM, Giordano G, Dao C, Chiron P, Puget J. The percutaneous compression plate (PCCP) in the treatment of trochanteric hip fractures in elderly patients. Acta Orthop Belg. 2006;72(3):314–9.PubMed

19.

Kosygan KP, Mohan R, Newman RJ. The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. J Bone Joint Surg Br. 2002;84:19–22.PubMedCrossRef

20.

Peyser A, Weil Y, Brocke L, Manor O, Mosheiff R, Liebergall M. Percutaneous compression plating versus compression hip screw fixation for the treatment of intertrochanteric hip fractures. Injury. 2005;36(11):1343–9.PubMedCrossRef

21.

Brandt E, Verdonschot N, van Vugt A, van Kampen A. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in intracapsular hip fractures: experimental assessment using synthetic and cadaver bones. Injury. 2006;37(10):979–83.PubMedCrossRef

Title: A comparative study between gamma nail and percutaneous compression plating for the treatment of intertrochanteric hip fractures
Authors: E. Crespo
J. Galvez
J. M. Tenías
I. Cano
R. Crespo
V. Palacios
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2012
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-012-0181-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A comparative study between gamma nail and percutaneous compression plating for the treatment of intertrochanteric hip fractures

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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