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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2003 February;54(1):23-7
Treatment of unstable pertrochanteric fractures using revision prosthesis (biarticular cervical cephalic). Long stem femural component
Salvi A. E. 1, Metelli G. P. 2, Pazzaglia U. E. 1
1 2° Divisione di Ortopedia e Traumatologia Clinica Ortopedica dell’Università Università degli Studi di Brescia Spedali Civili di Brescia, Brescia
2 Divisione di Ortopedia e Traumatologia Azienda Ospedaliera “Mellino Mellini” Presidio Ospedaliero, Iseo (Brescia)
Aim. The traditional approach treatment for some kinds of pertrochanteric fractures is often unpleasant due to their particular instability. In the literature traditional treatments using dynamic hip screw (DHS), nail and plaster are described but the results are frequently not the hoped ones. The authors report their experience in treating these fractures using a peculiar long stem hip prosthesis.
Methods. At the Orthopaedic and Traumatologic Division of the Civil Hospital of Iseo (BS), from May 1999 to February 2001, 36 pertrochanteric plurifragmentary fractures were treated using the biarticular endoprosthesis called “Stylos” and 1 pertrochanteric plurifragmentary fracture was treated using the arthroprostesis “Kyra”. The surgical approach used was the Hardinge-McFarland-Osborne. Rehabilitation started at the 3rd postoperative day, after removal of the draining at the 2nd postoperative day. Assisted walking is permitted at the 6th postoperative day in case the patient could walk before the trauma.
Results. The results obtained seem to be encouraging, since bed-sores were never observed bed-sores and patients have never complained pain. These facts have permitted a good collaboration in the functional recovering stage. Only 1 case of prosthesis dislocation has been reported.
Conclusions. The use of a particular revision prosthesis has permitted to overcome traditional problems of conventional surgical treatment and conservative treatment. As a matter of fact, patients not complaining pain and being able to walk rapidly, have been more cooperating in shortening recovery times. However, the cost of this prosthesis seems to be a disadvantage in the treatment.