[Clinical study for preoperative traction on impact of osteonecrosis of femoral head in patients with femoral neck fractures].

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 19. Injury. 2016 Feb;47(2):424-7. doi: 10.1016/j.injury.2015.10.054. Epub 2015 Oct 30. Dynamic locking plate vs. simple cannulated screws for nondisplaced intracapsular hip fracture: A comparative study. Warschawski Y(1), Sharfman ZT(1), Berger O(2), Steinberg EL(1), Amar E(1), Snir N(3). Author information: (1)Division of Orthopedic Surgery, Tel Aviv Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. (2)Division of Orthopedic Surgery, Hillel Yaffe Medical Center, Hadera, Israel. (3)Division of Orthopedic Surgery, Tel Aviv Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: drnimrodsnir@gmail.com. Comment in Injury. 2016 Jun;47(6):1360. doi: 10.1016/j.injury.2016.03.037. INTRODUCTION: Intracapsular hip fractures (ICHF) are a common cause of morbidity and mortality and pose a great economic burden on the health care systems. Appropriate surgical treatment requires balancing optimal outcomes with the cost of treatment to the health care system. While in elderly patients with displaced ICHF arthroplasty became the standard of care, the internal fixation method for conserving the femoral head in younger patients or in nondisplaced ICHF is still in debate. We compared a dynamic locking plate with the standard cancellous cannulated screws (CCS) for treatment of nondisplaced ICHF. METHODS: All patients treated with internal fixation for nondisplaced ICHF between July 2009 and December 2012 at our level one trauma center were included in this study. Patients treated with Targon FN (Aesculap) implants and CCS (Synthes) were compared. Charts were reviewed for demographics, intraoperative data and peri/post operative complications retrospectively. Radiographical analysis, pain (VAS), quality of life (SF12) and function (MHHS) data were prospectively gathered. RESULTS: One hundred and fifteen non-displaced ICHFs were treated with internal fixation, 81 with CCS and 34 with Targon FN implant; the mean follow-up was 19 and 28 months, respectively. Group fracture characteristics (Garden/Powel classification), and demographics, excluding age, were not significantly different. Post-operative revision rates of the Targon FN and CCS groups, perioperative complications were not statistically different (p>0.05). Quality of life (SF-12), function (Modified Harris Hip Score) and Visual Analogue Scale (VAS) pain scores were not statistical different. CONCLUSIONS: Complication rates and clinical outcomes for the treatment of nondisplaced ICHF with Targon FN and SCC showed no significant differences. Based on this evidence in consideration of the substantial cost differential between the Targon FN and SCC we suggest SCC for treatment of nondisplaced ICHF. LEVEL OF EVIDENCE: III. Copyright © 2015 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.injury.2015.10.054