Comparison of Outcomes of Intertrochanteric Fracture Fixation Using Percutaneous Compression Plate Between Stable and Unstable Fractures in the Elderly

J Orthop Trauma. 2016 Jun;30(6):e201-6. doi: 10.1097/BOT.0000000000000509.

Abstract

Objectives: To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures.

Design: Clinical prospective nonrandomized cohort study.

Setting: San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital.

Patients: Patients older than 65 years undergoing surgery for an intertrochanteric hip fracture (n = 657) were divided according to the OTA/AO classification, into stable (31-A1) (group A, n = 363) and unstable fractures (31-A2) (group B, n = 294).

Intervention: Osteosynthesis with a PCCP (Orthofix Inc).

Main outcome measurements: Blood loss, wound complications, postoperative pain, operative and fluoroscopy time, functional outcomes, device-related complications, consolidation time, and mortality.

Results: Patients with unstable fractures were significantly worse with respect to postoperative pain, immediately (P = 0.020), at 6 weeks (P = 0.0001), and at 3 months (P = 0.009), and with respect to independent walking ability at 6 weeks. No other significant differences were observed.

Conclusions: The outcomes of osteosynthesis with PCCP seem to be equally satisfactory in stable and unstable intertrochanteric fractures, with stable fractures having less pain and a greater ability to walk earlier.

Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Bone Plates*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Geriatric Assessment
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / surgery*
  • Hospitals, University
  • Humans
  • Injury Severity Score
  • Joint Instability / diagnostic imaging
  • Joint Instability / surgery*
  • Male
  • Pain Measurement*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Prospective Studies
  • Recovery of Function
  • Risk Assessment
  • Spain
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Walking