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https://hdl.handle.net/2440/106313
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Type: | Journal article |
Title: | Comparison of stable and unstable pertrochanteric femur fractures managed with 2- and 4-hole side plates |
Author: | Baird, R. O'Brien, P. Cruickshank, D. |
Citation: | Canadian Journal of Surgery, 2014; 57(5):327-330 |
Publisher: | Canadian Medical Association |
Issue Date: | 2014 |
ISSN: | 0008-428X 1488-2310 |
Statement of Responsibility: | Robert Peter Baird, Peter O’Brien, David Cruickshank |
Abstract: | BACKGROUND: Sliding hip screw (SHS) fixation traditionally involves the use of 4-hole side plates; however, 4-hole plates have disadvantages, including longer surgery and greater postoperative pain, and there is little evidence that they provide increased stability. We compared 2- and 4-hole side plates in stable and unstable pertrochanteric fractures. METHODS: We prospectively enrolled consecutive patients with pertrochanteric femoral fractures treated between Jan. 1, 2004, and Apr. 30, 2009, with a 135° SHS using either a 2- or 4-hole side plate, based on surgeon preference. RESULTS: A total of 327 patients were managed with an SHS device (252 women, 75 men). There were 208 stable fracture patterns (AO/OTA 31 A1, A2.1) and 119 unstable (AO/OTA 31 A2.2, A2.3, A3). We managed 172 patients with 2-hole plates and 155 with 4-hole plates. The average duration of surgery (30.44 v. 51.45 min), blood loss (26.0 v. 31.3 g/L) and transfusion requirements (43% v. 31. 60% transfusion) were significantly lower with the 2-hole than the 4-hole plate. There was no significant difference in length of stay (19 v. 16 d). With stable fractures there was no significant difference in failure rate (6.3% v. 4.9%). In unstable fractures there was a significantly higher rate of failure using 2-hole side plates (24.4% v. 10.8%). CONCLUSION: In stable fractures, use of an SHS with a 2-hole side plate results in shorter surgery and less blood loss/transfusion than a 4-hole side plate, with equivalent survival. In unstable fractures, there is a greater than 2-fold rate of failure when a 2-hole side plate is used. |
Keywords: | Bone Screws |
Rights: | © 2014 Canadian Medical Association |
DOI: | 10.1503/cjs.026113 |
Published version: | http://dx.doi.org/10.1503/cjs.026113 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
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