Gamma nail versus percutaneous compression plate for the treatment of intertrochanteric hip fractures: a multicenter pair-matched study.
Fracture fixation
Functional outcome
Gamma nail
Intertrochanteric fracture
Percutaneous compression plate
Survival
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
24
10
2022
accepted:
14
11
2022
medline:
27
7
2023
pubmed:
20
12
2022
entrez:
19
12
2022
Statut:
ppublish
Résumé
To compare functional outcomes, complication rates, and survival in patients with intertrochanteric fracture treated with percutaneous compression plate (PCCP) or gamma nail (GN). A retrospective study of prospectively collected data of patients treated with PCCP or GN for AO/OTA 31.A1 or AO/OTA 31.A2 fractures was conducted. Sixty-eight consecutive patients treated with PCCP between 2018 and 2020 were enrolled and matched with 68 patients with comparable characteristics treated with GN. The activities of daily living (ADL) index and specific scales for walking ability and need for walking aids at 4 months and 1 year after fracture fixation were chosen as primary outcomes. Postoperative complications and one-year survival were recorded and compared between the two groups. Walking ability and ADLs index decreased and the need for walking aids increased in both groups compared to the prefracture state at both follow-up intervals (p < 0.001), regardless of the treatment received. There was no difference between the two implants in the rate of implant-related complications. One-year survival rate was 78.9% (95% CI 67.0-86.9) and 82.4% (95% CI 71.0-89.5) in patients undergoing PCCP or GN, respectively, with no significant difference between the two groups. Walking ability, ADLs, complication rate, and 1-year survival are not significantly different when patients undergoing PCCP or GN are compared. The choice of implant may not be decisive for the outcome of treatment of intertrochanteric fractures, provided that stable fixation is ensured.
Identifiants
pubmed: 36534367
doi: 10.1007/s00590-022-03441-6
pii: 10.1007/s00590-022-03441-6
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2445-2452Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Magaziner J, Hawkes W, Hebel JR et al (2000) Recovery from hip fracture in eight areas of function. J Gerontol Biol Sci Med Sci 55:M498-507
doi: 10.1093/gerona/55.9.M498
Vochteloo AJH, Moerman S, Tuinebreijer WE et al (2013) More than half of hip fracture patients do not regain mobility in the first postoperative year. Geriatr Gerontol Int 13:334–341
doi: 10.1111/j.1447-0594.2012.00904.x
pubmed: 22726959
Mariconda M, Costa GG, Cerbasi S et al (2016) Factors predicting mobility and the change in activities of daily living after hip fracture: a 1-year prospective cohort study. J Orthop Trauma 30:71–77
doi: 10.1097/BOT.0000000000000448
pubmed: 26817573
Fox KM, Magaziner J, Hebel JR, Kenzora JE, Kashner TM (1999) Intertrochanteric versus femoral neck hip fractures: differential characteristics, treatment, and sequelae. J Gerontol Biol Sci Med Sci 54:M635-640
doi: 10.1093/gerona/54.12.M635
Yang E, Qureshi S, Trokhan S, Joseph D (2011) Gotfried percutaneous compression plating compared with sliding hip screw fixation of intertrochanteric hip fractures: a prospective randomized study. J Bone Joint Surg Am 93:942–947
doi: 10.2106/JBJS.I.00849
pubmed: 21593370
Arirachakaran A, Amphansap T, Thanindratarn P, Piyapittayanun P, Srisawat P, Kongtharvonskul J (2017) Comparative outcome of PFNA, gamma nails, PCCP, medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials. Eur J Orthop Surg Traumatol 27:937–952
doi: 10.1007/s00590-017-1964-2
pubmed: 28434124
Kim WY, Han CH, Park JI, Kim JY (2001) Failure of intertrochanteric fracture fixation with a dynamic hip screw in relation to pre-operative fracture stability and osteoporosis. Int Orthop 25:360–362
doi: 10.1007/s002640100287
pubmed: 11820441
pmcid: 3620783
Knobe M, Gradl G, Ladenburger A, Tarkin IS, Pape HC (2013) Unstable intertrochanteric femur fractures: is there a consensus on definition and treatment in Germany? Clin Orthop Relat Res 471:2831–2840
doi: 10.1007/s11999-013-2834-9
pubmed: 23389806
pmcid: 3734428
Zhang L, Shen J, Yu S, Huang Q, Xie Z (2014) Percutaneous compression plate versus dynamic hip screw for treatment of intertrochanteric hip fractures: a meta-analyse of five randomized controlled trials. Sci World J 2014:512512
Bojan AJ, Beimel C, Speitling A, Taglang G, Ekholm C, Jönsson A (2010) 3066 consecutive gamma nails. 12 years experience at a single centre. BMC Musculoskelet Disord 11:133
doi: 10.1186/1471-2474-11-133
pubmed: 20579384
pmcid: 2906434
Varela-Egocheaga JR, Iglesias-Colao R, Suárez-Suárez MA, Fernández-Villán M, González-Sastre V, Murcia-Mazón A (2009) Minimally invasive osteosynthesis in stable trochanteric fractures: a comparative study between gotfried percutaneous compression plate and gamma 3 intramedullary nail. Arch Orthop Trauma Surg 129:1401–1407
doi: 10.1007/s00402-009-0955-0
pubmed: 19672606
Gotfried Y (2000) Percutaneous compression plating of intertrochanteric hip fractures. J Orthop Trauma 14:490–495
doi: 10.1097/00005131-200009000-00005
pubmed: 11083611
Gotfried Y, Cohen B, Rotem A (2002) Biomechanical evaluation of the percutaneous compression plating system for hip fractures. J Orthop Trauma 16:644–650
doi: 10.1097/00005131-200210000-00006
pubmed: 12368645
Ropars M, Mitton D, Skalli W (2008) Minimally invasive screw plates for surgery of unstable intertrochanteric femoral fractures: a biomechanical comparative study. Clin Biomech 23:1012–1017
doi: 10.1016/j.clinbiomech.2008.04.018
Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychological function. JAMA 185:914–919
doi: 10.1001/jama.1963.03060120024016
pubmed: 14044222
Hoffer MM, Feiwell E, Perry R, Perry J, Bonnett C (1973) Functional ambulation in patients with myelomeningocele. J Bone Joint Surg Am 55:137–148
doi: 10.2106/00004623-197355010-00014
pubmed: 4570891
Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD (1995) Ambulatory ability after hip fracture. A prospective study in geriatric patients. Clin Orthop Relat Res 310:150–159
Mariconda M, Costa G, Misasi M, Recano P, Balato G, Rizzo M (2017) Ambulatory ability and personal independence after hemiarthroplasty and total arthroplasty for intracapsular hip fracture: a prospective comparative study. J Arthroplasty 32:447–452
doi: 10.1016/j.arth.2016.07.017
pubmed: 27546471
Holt G, Smith R, Duncan K, Hutchison JD, Gregori A (2008) Epidemiology and outcome after hip fracture in the under 65s-evidence from the scottish hip fracture audit. Injury 39:1175–1181
doi: 10.1016/j.injury.2008.04.015
pubmed: 18703186
Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
doi: 10.1016/0022-3956(75)90026-6
pubmed: 1202204
Linn BS, Linn MW, Gurel L (1968) Cumulative illness rating scale. J Am Geriatr Soc 16:622–626
doi: 10.1111/j.1532-5415.1968.tb02103.x
pubmed: 5646906
Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF (2018) Fracture and dislocation classification compendium-2018. J Orthop Trauma 32(Supplement 1):S1–S170
doi: 10.1097/BOT.0000000000001063
pubmed: 29256945
Jegathesan T, Kwek EBK (2022) Are intertrochanteric fractures evolving? Trends in the elderly population over a 10-year period. Clin Orthop Surg 14:13–20
doi: 10.4055/cios20204
Mariconda M, Costa GG, Cerbasi S, Recano P, Aitanti E, Gambacorta M et al (2015) The determinants of mortality and morbidity during the year following fracture of the hip: a prospective study. Bone Joint J 97-B:383–390
doi: 10.1302/0301-620X.97B3.34504
pubmed: 25737523
Giancola R, Antonini G, Delle Rose G, Crippa C (2008) Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fractures. Strategies Trauma Limb Reconstr 3:9–14
doi: 10.1007/s11751-008-0032-1
pubmed: 18427918
pmcid: 2291479
Yan SG, Zhao X, Li H, Zheng Q, Li JB, Pan ZJ, Wu HB (2011) Comparison of percutaneous compression plating and short reconstruction nail for treatment of intertrochanteric fracture. Orthop Surg 3:14–21
doi: 10.1111/j.1757-7861.2010.00117.x
pubmed: 22009975
pmcid: 6583571
Crespo E, Galvez J, Tenías JM, Cano I, Crespo R, Palacios V (2012) A comparative study between gamma nail and percutaneous compression plating for the treatment of intertrochanteric hip fractures. Eur J Trauma Emerg Surg 38:443–449
doi: 10.1007/s00068-012-0181-2
pubmed: 26816126
Knobe M, Drescher W, Heussen N, Sellei RM, Pape HC (2012) Is helical blade nailing superior to locked minimally invasive plating in unstable pertrochanteric fractures? Clin Orthop Relat Res 470:2302–2312
doi: 10.1007/s11999-012-2268-9
pubmed: 22311725
pmcid: 3392400
Guo Q, Shen Y, Zong Z, Zhao Y, Liu H, Hua X et al (2013) Percutaneous compression plate versus proximal femoral nail anti-rotation in treating elderly patients with intertrochanteric fractures: a prospective randomized study. J Orthop Sci 18:977–986
doi: 10.1007/s00776-013-0468-0
pubmed: 24085380
pmcid: 3838589
Utrilla AL, Reig JS, Muñoz FM, Tufanisco CB (2005) Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma 19:229–233
doi: 10.1097/01.bot.0000151819.95075.ad
pubmed: 15795570
Parker MJ, Bowers TR, Pryor GA (2012) Sliding hip screw versus the targon PF nail in the treatment of trochanteric fractures of the hip: a randomised trial of 600 fractures. J Bone Joint Surg Br 94B:391–397
doi: 10.1302/0301-620X.94B3.28406
Zehir S, Zehir R, Zehir S, Azboy İ, Haykir N (2015) Proximal femoral nail antirotation against dynamic hip screw for unstable trochanteric fractures; a prospective randomized comparison. Eur J Trauma Emerg Surg 41:393–400
doi: 10.1007/s00068-014-0463-y
pubmed: 26037995
Aktselis I, Kokoroghiannis C, Fragkomichalos E, Koundis G, Deligeorgis A, Daskalakis E et al (2014) Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur. Int Orthop 38:155–161
doi: 10.1007/s00264-013-2196-7
pubmed: 24318319
Gaddi D, Piarulli G, Angeloni A, Gandolla M, Munegato D, Bigoni M (2014) Gotfried percutaneous compression plating (PCCP) versus dynamic hip screw (DHS) in hip fractures: blood loss and 1-year mortality. Aging Clin Exp Res 26:497–503
doi: 10.1007/s40520-014-0205-3
pubmed: 24633649
Saarenpää I, Heikkinen T, Ristiniemi J, Hyvönen P, Leppilahti J, Jalovaara P (2009) Functional comparison of the dynamic hip screw and the gamma locking nail in trochanteric hip fractures: a matched-pair study of 268 patients. Int Orthop 33:255–260
doi: 10.1007/s00264-007-0458-y
pubmed: 17943284
Parker MJ, Handoll HH (2008) Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev 3:CD000093
Yu X, Wang H, Duan X, Liu M, Xiang Z (2018) Intramedullary versus extramedullary internal fixation for unstable intertrochanteric fracture, a meta-analysis. Acta Orthop Traumatol Turc 52:299–307
doi: 10.1016/j.aott.2018.02.009
pubmed: 29602699
pmcid: 6150441
Kosygan KP, Mohan R, Newman RJ (2002) The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. J Bone Joint Surg Br 84B:19–22
doi: 10.1302/0301-620X.84B1.0840019
Orabona N, Bove A, Smeraglia F, Rizzo M, Russo B, Traficante F et al (2019) The impact of hemodialysis on mortality and personal independence after hip fracture: a prospective matched cohort study. J Orthop Trauma 33:577–582
doi: 10.1097/BOT.0000000000001556
pubmed: 31188256