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Panminerva Medica 1999 September;41(3):233-7

lingua: Inglese

Dynamic hip screw versus 3 parallel screws in the treatment of garden 1+2 and garden 3+4 cervical hip fractures

Levi N.

From the Department of Orthopaedic Surgery, Rigshospitalet University of Copenhagen, Denmark, Department of Orthopaedic Surgery, Frederiksberg Hospital University of Copenhagen, Denmark


Objective. The ­main ob­jec­tive of ­this ­study was to eval­u­ate the fail­ure ­rate fol­low­ing op­er­a­tions of un­dis­placed and dis­placed cer­vi­cal hip frac­tures ­with a dy­nam­ic hip ­screw com­pared ­with 3 par­allel ­screws.
Design. The ­study was ret­ro­spec­tive. The min­i­mum fol­low-up ­time was 1 ­year. The ­data tta col­lest­ed ­between January 1990 and December 1993.
Setting. University Hospitals.
Patients. A to­tal of 456 pa­tients (352 wom­en and 104 men) ­with cer­vi­cal hip frac­tures ­were in­clud­ed. The ­mean age was 80 ­years (­range 51-100 ­years).
Intervention. This was inter­nal fix­a­tion of the frac­tured hip ­with a dy­nam­ic hip ­screw or 3 par­allel ­screws.
Main out­come meas­ures. Failure was de­fined as non­un­ion, fix­a­tion fail­ure or avas­cu­lar ne­cro­sis and re­op­er­a­tion was ­found in­di­cat­ed. The 3 ­months mor­tal­ity ­rate, the ­wound in­fec­tion ­rate, the de­lay ­between ad­mis­sion and ­time of sur­gery and the ­blood trans­fu­sion re­quire­ment ­were al­so re­cord­ed.
Results. A to­tal of 456 cer­vi­cal hip frac­tures ­were op­er­at­ed ­with a dy­nam­ic hip ­screw or 3 par­allel ­screws. The fail­ure ­rate for frac­tures treat­ed ­with a dy­nam­ic hip ­screw was 14/98=14% for Garden 1+2 frac­tures and 43/108=40% for Garden 3+4 frac­tures. The fail­ure ­rate for frac­tures treat­ed ­with 3 par­allel ­screws was sim­i­lar: 23/154=15% for Garden 1+2 frac­tures and 38/196=40% for Garden 3+4 frac­tures. The av­er­age fol­low-up ­time was 2.5 ­years.
Conclusion. Operation of cer­vi­cal hip frac­ture ­with a dy­nam­ic hip ­screw or 3 par­allel ­screws ­seem to ­give sim­i­lar re­sults.

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