TITLE

A Comparison of the Long Gamma Nail with the Sliding Hip Screw for the Treatment of AO/OTA 31-A2 Fractures of the Proximal Part of the Femur

AUTHOR(S)
Barton, Tristan M.; Gleeson, Robert; Topliss, Claire; Greenwood, Rosemary; Harries, William J.; Chesser, Timothy J. S.
PUB. DATE
April 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Apr2010, Vol. 92-A Issue 4, p792
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Controversy exists with regard to whether to treat AO/OTA 31-A2 fractures of the proximal part of the femur with an intramedullary device or an extramedullary device. A prospective, randomized, controlled trial was performed to compare the outcome of treatment of these unstable fractures of the proximal part of the femur with either a sliding hip screw or a long gamma nail. Methods: Two hundred and ten patients presenting with an AO/OTA 31-A2 fracture of the proximal part of the femur were randomized, at the time of admission, to fixation with use of either a long gamma nail or a sliding hip screw. The primary outcome measure was reoperation within the first postoperative year. Secondary measures included mortality, length of hospital stay, transfusion rate, change in mobility and residence, and quality of life as measured with the EuroQol 5D outcome score. Results: There was no significant difference between the reoperation rates for the two groups. In total, five patients (three from the long-gamma-nail group and two from the sliding-hip-screw group) underwent revision surgery because of cut-out. Tip-apex distance was found to correlate with the implant cut-out rate. There was no significant difference between the two groups in terms of the EuroQol 5D outcome scores, the mortality rates after correction for the mini-mental score, or any of the secondary outcome measures. Conclusions: When compared with the long gamma nail, the sliding hip screw should remain the gold standard for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur because it is associated with similar outcomes with less expense.
ACCESSION #
49475994

 

Related Articles

  • 밴쿠버 분류 B2와 B3 삽입물 주위 골절을 위한 대퇴 스템 재치환술. 성윤재; 신원철; 조형준; 이정섭; 서근택 // Journal of the Korean Orthopaedic Association;Jun2013, Vol. 48 Issue 3, p197 

    Purpose: We evaluated the outcome of femoral stem revision for Vancouver B2 and B3 periprosthetic femoral fractures. Materials and Methods: We conducted a retrospective assessment of 15 patients who had received treatment for a periprosthetic unstable femoral fracture after primary hip...

  • Repeat LISS treatment for femoral shaft fractures due to hardware failure: a retrospective analysis of eleven cases. Li, Xu; Xu, Xian; Liu, Lin; Shao, Qin; Wu, Wei // European Journal of Orthopaedic Surgery & Traumatology;Oct2013, Vol. 23 Issue 7, p797 

    Objective: To evaluate the effectiveness of a replating technique having a less-invasive stabilization system (LISS) for femoral shaft fractures due to LISS failure in adults. Patients and methods: There were 11 patients with hardware failure of LISS for femoral shaft fractures, on an average of...

  • Outcomes of length-stable fixation of femoral neck fractures. Boraiah, Sreevathsa; Paul, Omesh; Gardner, Michael; Parker, Robert; Barker, Joseph; Helfet, David; Lorich, Dean // Archives of Orthopaedic & Trauma Surgery;Dec2010, Vol. 130 Issue 12, p1523 

    Introduction: The most common implants for treating unstable femoral neck fractures are sliding constructs, which allow postoperative collapse. Successful healing, typically, is a malunion with a shortened femoral neck. Functional sequelae resulting from altered femoral neck biomechanics have...

  • Nonoperatively treated type A spinal fractures: mid-term versus long-term functional outcome. R. Post; V. Leferink; P. Dijkstra; H. ten Duis // International Orthopaedics;Aug2009, Vol. 33 Issue 4, p1055 

    Abstract��This study focuses on the mid-term (four�years) and long-term (ten�years) functional outcome of patients treated nonoperatively for a type A spinal fracture without primary neurological deficit. Functional outcome was measured using the visual analogue scale spine...

  • Subtalar Fusion After Displaced Intra-Articular Calcaneal Fractures: Does Initial Operative Treatment Matter? Radnay, Craig S.; Clare, Michael P.; Sanders, Roy W. // Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p541 

    Background: Many patients with displaced intra-articular calcaneal fractures require subtalar arthrodesis for the treatment of posttraumatic arthritis. We hypothesized that patients who underwent initial operative treatment would have better functional outcomes as compared with those who...

  • Quality of Life After Volar Plate Fixation of Articular Fractures of the Distal Part of the Radius. Gruber, Gerald; Zacherl, Max; Giessauf, Christian; Glehr, Mathias; Fuerst, Florentine; Liebmann, Walter; Gruber, Karl; Bernhardt, Gerwin Alexander // Journal of Bone & Joint Surgery, American Volume;May2010, Vol. 92-A Issue 5, p1170 

    Background: Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked...

  • The effect of surgical timing on the outcome of patients with neck of femur fracture. Lim, Aik; Lane, Stephen; Page, Richard; Lim, Aik Honn // Archives of Orthopaedic & Trauma Surgery;Nov2015, Vol. 135 Issue 11, p1497 

    Aims: To investigate the effect of surgical timing (in hours versus after hours and weekdays versus weekends) on the outcome of patients with neck of femur fracture.Methods: Patients who were admitted to a single tertiary referral hospital for surgical management of...

  • Tantalum Cones Provide Durable Mid-term Fixation in Revision TKA. Martino, Ivan; Santis, Vincenzo; Sculco, Peter; D'Apolito, Rocco; Assini, Joseph; Gasparini, Giorgio // Clinical Orthopaedics & Related Research;Oct2015, Vol. 473 Issue 10, p3176 

    Background: Multiple studies have reported favorable short-term outcomes using tantalum cones to reconstruct massive bone defects during revision TKA. However, longer-term followup is needed to determine the durability of these reconstructions. Questions/purposes: We wished to determine the...

  • Comparison of different locking plate fixation methods in distal tibia fractures. Piątkowski, Krzysztof; Piekarczyk, Piotr; Kwiatkowski, Krzysztof; Przybycień, Mateusz; Chwedczuk, Bartłomiej; Piątkowski, Krzysztof; Przybycień, Mateusz; Chwedczuk, Bartłomiej // International Orthopaedics;Nov2015, Vol. 39 Issue 11, p2245 

    Purpose: The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate.Methods: A retrospective...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics