Document Detail

DHS osteosynthesis for stable pertrochanteric femur fractures with a two-hole side plate.
MedLine Citation:
PMID:  15351666     Owner:  NLM     Status:  MEDLINE    
The sliding hip screw is the implant of choice for the operative treatment of stable pertrochanteric femur fractures (AO classification 31-A.1). For this indication, a four-hole side plate with four bicortical screws is widely used to allow full weight bearing immediately after operation, but scientific support for the need of such a long side plate is not available. A shorter side plate is potentially less invasive. Therefore, we retrospectively evaluated all 148 consecutive patients (median age 80 years) with a stable pertrochanteric femur fracture who were treated between 1995 and 2001 with a dynamic hip screw (DHS) and a short (two-hole) side plate and immediate full weight bearing mobilisation. Although two wound hematomas and four wound infections occurred, 145 fractures healed radiologically without implant-related complications within 6 months. Two hip screws cut out of the femoral head due to a poor position. In one patient, the side plate broke out after a fall out of bed on the fifth postoperative day. Pull off of any two-hole side plate during early full weight bearing mobilisation without further trauma was not observed. We conclude that fixation of stable pertrochanteric femur fractures with a two-hole DHS is safe. The traditional use of a four-hole DHS plate for this indication is therefore 'over-treatment' since it is more invasive.
Michiel H J Verhofstad; Chris van der Werken
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Injury     Volume:  35     ISSN:  0020-1383     ISO Abbreviation:  Injury     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-07     Completed Date:  2004-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  England    
Other Details:
Languages:  eng     Pagination:  999-1002     Citation Subset:  IM    
Department of Surgery, St Elisabeth Hospital, P.O. Box 90151, 5000 LC Tilburg, The Netherlands.
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MeSH Terms
Accidental Falls
Aged, 80 and over
Bone Plates
Bone Screws
Femoral Fractures / etiology,  surgery*
Fracture Fixation, Internal / instrumentation,  methods*
Internal Fixators
Middle Aged
Postoperative Complications / etiology
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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