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Panminerva Medica 2002 June;44(2):135-9

lingua: Inglese

Compression hip screw nail-plate system for intertrochanteric fractures

Maniscalco P., Rivera F., Bertone C., Urgelli S., Bocchi L.

From the Orthopaedic and Traumatologic Clinic, Department of Radiological and Orthopaedic - Rehabilitation Sciences, University of Siena, Siena, Italy


Background. The world­wide ­increased inci­dence in frac­tures of the prox­i­mal end of the ­femur is increas­ing ­with the par­allel ­increase in the aver­age age of the pop­u­la­tion. The ­advanced age and ­poor phys­i­cal con­di­tion of ­these ­patients ren­der sur­gery nec­es­sary.
Methods. In 1999, at the Orthopaedic Clinic of the University of Siena, 56 ­patients ­were treat­ed ­with the com­pres­sion hip ­nail-­plate ­system, a new syn­the­sis ­device for the treat­ment of per­i­troch­an­ter­ic frac­tures. The ­system con­sists of a new dynam­ic cephal­ic ­screw ­that ­could be com­bined ­with a ­plate or a femo­ral ­nail. The dynam­ic cephal­ic ­screw of the BCM ­system has a lim­it­ed slid­ing meth­od, imped­ing excur­sions great­er ­than 10 mm and pre­vent­ing exces­sive col­lapse of the frac­ture frag­ments ­that can ­evolve ­into a short­en­ing of the ­limb. The can­u­lat­ed ­nail has a diam­e­ter of ­only 9 mm, ­which per­mits inser­tion ­into the ­shaft ­canal with­out ream­ing.
Results. Four ­patients ­with a fol­low-up of ­less ­than 3 ­months, 2 ­patients ­lost to con­trol, and 1 ­patient who ­died ­were exclud­ed ­from the ­study. All 49 remain­ing ­patients ­healed clin­i­cal­ly and radio­graph­i­cal­ly with­in 3 ­months.
Conclusions. The pos­sibil­ity of the dou­ble com­bi­na­tion of the ­screw ­with a ­plate or ­with an intra­me­dul­lary ­nail per­mits the sur­geon to ­have a dou­ble solu­tion ­with a sin­gle instru­ment at ­hand, and ­offers the oppor­tu­nity of chang­ing the ­choice of syn­the­sis meth­od to ­implant ­even dur­ing sur­gery.

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