Perioperative Lateral Trochanteric Hip Fractures: Sliding Hip Screw Versus Percutaneous Compression Plate for Intertrochanteric Hip Fractures

2011 ◽  
Vol 25 (9) ◽  
pp. e95-e96
Author(s):  
Deepak Joshi ◽  
Arvind B Goregaonkar
Keyword(s):  
Hip Fractures ◽  
Sliding Hip Screw ◽  
Compression Plate ◽  
Hip Screw ◽  
Percutaneous Compression Plate

scholarly journals Is There Evidence that the Percutaneous Compression Plate Method of Internal Fixation for Intertrochanteric Hip Fractures Leads to Better Intraoperative and Postoperative Outcomes than the Dynamic Hip Screw?

2018 ◽  
Vol 9 ◽  
pp. 117956031877775 ◽  
Author(s):  
James M Halle-Smith ◽  
Alasdair JA Carnegy ◽  
Richard Carr ◽  
Arhfat Ahmed ◽  
Robert Wooley ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Blood Loss ◽  
Systematic Reviews ◽  
Hip Fractures ◽  
Mortality Rates ◽  
Dynamic Hip Screw ◽  
Postoperative Outcomes ◽  
Compression Plate ◽  
Hip Screw ◽  
Percutaneous Compression Plate

Background: Hip fractures are common, expensive and lead to considerable morbidity and mortality. An ageing population in the United Kingdom means that rates of this injury are increasing, making them a pressing public health issue. The National Institute of Health and Care Excellence (NICE) recommends that extramedullary implants are used over intramedullary nails to fix intertrochanteric fractures, which make up half of all hip fractures. However, there is currently no guidance on the preferred type of extramedullary device whether this be the commonly used dynamic hip screw (DHS) or another newer device. It has been suggested that a percutaneous compression plate (PCCP) can reduce complications and improve functional outcome compared with the traditional DHS. Review Question: In patients with intertrochanteric hip fractures, is the PCCP more effective than the DHS in terms of relevant intraoperative and postoperative outcomes such as blood loss, implant failure, and mortality? Literature Search: We first searched for relevant information in the NICE Clinical Guideline on Hip Fracture Management (CG124), then National Health Service (NHS) evidence for Clinical Knowledge Summaries, then the Cochrane library for systematic reviews. Finally, we conducted an electronic search of the PubMed database. Review Findings: We selected five systematic reviews and eight primary studies for review. The main findings were that the PCCP was associated with significantly less blood loss, fewer blood transfusions, and shorter operating times compared with the DHS. However, no significant differences were found in postoperative pain, orthopaedic performance, and mortality rates between the two methods. There was no comparison of cost-effectiveness between the two methods. Conclusions: The PCCP is superior to the DHS in terms of intraoperative blood loss and, potentially, non-orthopaedic postoperative complications such as deep vein thrombosis and nosocomial infection. However, there was no significant difference in mortality rates between the two methods. Current studies on this topic have several methodological issues and some are of relatively poor quality. Further higher quality research and cost-effectiveness are necessary to further evaluate the efficacy of these methods.

scholarly journals Functional Recovery Following Pertrochanteric Hip Fractures Fixated with the Dynamic Hip Screw vs. the Percutaneous Compression Plate

2005 ◽  
Vol 5 ◽  
pp. 221-229 ◽  
Author(s):  
Yocheved Laufer ◽  
Miriam Lahav ◽  
Reuben Lenger ◽  
Elliot Sprecher
Keyword(s):  
Hip Fractures ◽  
Functional Recovery ◽  
Weight Bearing ◽  
Assistive Devices ◽  
Dynamic Hip Screw ◽  
Elderly Subjects ◽  
Number Of Patients ◽  
Compression Plate ◽  
Hip Screw ◽  
Percutaneous Compression Plate

The Dynamic Hip Screw (DHS) is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP) is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 ± 5.5) following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL). While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results.

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