Trochanteric locking nail versus arthroplasty in unstable intertrochanteric fracture in patients aged over 75 years - 24/09/11
, D. Saragaglia b, M. Ehlinger c, J. Tonetti d, N. Maisse e, P. Adam c, C. Le Gall aFrench Hip and Knee Society (SFHG), Trauma Surgery Academy (GETRAUM)
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Summary |
Introduction |
In trochanteric fracture, whatever its anatomic type, internal fixation is currently the standard attitude, with arthroplasty as a relatively unusual option.
Hypothesis |
Hip implants are an excellent alternative to osteosynthesis in unstable trochanteric fracture in patients aged over 75 years.
Patients and methods |
A non-randomised prospective multicenter study compared osteosynthesis by trochanteric nailing (n=113) to hip arthroplasty (n=134) in unstable trochanteric fracture (AO types 31 A2.2 and 3 and A3.3) in 247 patients over the age of 75 years. The series was recruited during 2007 in seven centres, four of which included only arthroplasties, two only osteosyntheses and one both. The two groups were comparable in age, sex, preoperative Parker score, pre-fracture place of residence, fracture type, time to surgery and preoperative comorbidity. The sole difference was in operators, with more senior surgeons in arthroplasty (62% versus 27%).
Results |
Three-month mortality was identical in the two groups (21.2% versus 21%). General complications did not differ, although mechanical complications were more frequent in the nailing group (12.5% versus 2.8%). Functional results (Parker and PMA scores) were better in the implant than in the nail group.
Discussion |
The present study validated hip arthroplasty in these indications. Cemented stems associated to a dual-mobility acetabular component gave the best results.
Type of study |
Prospective, level of evidence III.
El texto completo de este artículo está disponible en PDF.Keywords : Trochanteric fracture, Proximal femoral extracapsular fracture, Hip arthroplasty, Trochanteric locking nail
Esquema
 | The GETRAUM and SFHG, two SoFCOT affiliate societies, met to discuss a shared topic of interest at the interface between the elective orthopaedics and traumatology. The present article is the result of this study. |
Vol 97 - N° 6S
P. S95-S100 - octobre 2011 Regresar al número
Artículo precedente
- Primary total knee arthroplasty in the management of epiphyseal fracture around the knee
- S. Parratte, P. Bonnevialle, G. Pietu, D. Saragaglia, B. Cherrier, J.M. Lafosse
- SFCR Editorial Board
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.