[Weight-bearing early after osteosynthesis of the femoral neck by nail-plate (100 cases)].
One hundred trochanteric or transcervical fractures, 64 of which were in patients more than 75 years old, were treated by internal fixation with a THS nail-plate. This device is characterised by a better bending strength than a one-piece nail-plate and a design which limits the risk of displacement of the screw in the head so that immediate weight-bearing can be allowed. Weight was borne on the limb in 81 cases at the tenth post-operative day. It did not improve the mortality, there being 17 deaths by the third month but it greatly helped post-operative care and rehabilitation without producing any additional complications. As a result, 43 per cent of patients could return home by the 45th post-operative day and 74 per cent had recovered their previous level of autonomy within three months of operation. There were only four mechanical complications, all in transcervical fractures: one crack fracture in the femoral head and three displacements following inadequate reduction, treated by prosthetic replacement. The follow-up of 80 patients at three months showed that consolidation always developed between the 45th and 90th day with full weight-bearing and a stable radiological picture. There was no intra-articular penetration or bending of the screw and no break-out of the implant. Whilst it is a definite advance in the treatment of trochanteric fractures, a longer follow-up is needed to determine its place compared with prostheses in transcervical fractures.
Langlais
F
F
Service de Chirurgie Orthopédique, Traumatologie et Réparatrice (SCOR), C.H.U. Hôpital Sud, Rennes.
Burdin
P
P
Bourgin
T
T
Sassi
N
N
Levasseur
M
M
Chagneau
F
F
D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005264:Femoral Fractures / Q000601:surgery; D005265:Femoral Neck Fractures / Q000601:surgery*; D005272:Femur Neck / Q000473:pathology / Q000503:physiopathology; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period
Appui précoce après ostéosynthèse du col fémoral par vis plaque (100 cas).