One hundred elderly patients who had an intertrochanteric femoral fracture were randomized to treatment with a compression hip-screw with a plate (fifty patients) or a new intramedullary device, the intramedullary hip-screw (fifty patients).
All patients were followed prospectively for one year or until death.
A detailed assessment of the functional status and the plain radiographs of the hip was performed one, three, six, and twelve months postoperatively.
The two treatment groups were strictly comparable.
The operative time needed to insert the intramedullary hip-screw was significantly greater than that needed to insert the compression hip-screw with the plate (p=0.02), but use of the intramedullary hip-screw was associated with less estimated intraoperative blood loss (p=0.011).
The prevalence of perioperative complications, such as bronchopneumonia, cardiac failure, and urinary tract infection, was comparable in the two treatment groups.
There were one intraoperative fracture of the femoral shaft and two intraoperative fractures of the greater trochanter in the group managed with the intramedullary hip-screw.
One patient had pulling-out of the compression hip-screw on the seventh postoperative day.
Four patients had a trochanteric wound hematoma, without infection, after insertion of an intramedullary hip-screw.
All but one of the fractures healed.
The one non-union, which was in a patient who had a compression hip-screw, was treated with a hemiarthroplasty. (...)
Mots-clés Pascal : Fracture intertrochantérienne, Fémur, Vieillard, Homme, Ostéosynthèse, Enclouage centromédullaire verrouillé, Etude comparative, Technique, Fixation, Interne, Epidémiologie, Complication, Pronostic, Os, Membre inférieur, Système ostéoarticulaire pathologie, Traumatisme, Chirurgie orthopédique, Clou Gamma
Mots-clés Pascal anglais : Intertrochanteric fracture, Femur, Elderly, Human, Osteosynthesis, Interlocking intramedullary nailing, Comparative study, Technique, Fixation, Internal, Epidemiology, Complication, Prognosis, Bone, Lower limb, Diseases of the osteoarticular system, Trauma, Orthopedic surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0286477
Code Inist : 002B25I. Création : 27/11/1998.