HA-coated screws decrease the incidence of fixation failure in osteoporotic trochanteric fractures.
This study was done to determine if elderly patients with trochanteric fractures and with osteoporosis could benefit from treatment with a dynamic hip screw fixed with HA-coated AO/ASIF screws. One hundred twenty patients with AO, A1, or A2 trochanteric fractures were selected. Patients were divided into two groups and randomized to receive a 135 degree-four-hole dynamic hip screw fixed with either standard lag and cortical AO/ASIF screws (Group A), or HA-coated lag and cortical AO/ASIF screws (Group B). Lag screw cutout occurred in four patients in Group A, but not in any patients in Group B. In Group A, the femoral neck shaft angle was 134 degrees +/- 5 degrees postoperatively and 127 degrees +/- 12 degrees at 6 months. In Group B, the femoral neck shaft angle was 134 degrees +/- 7 degrees postoperatively and 133 degrees +/- 7 degrees at 6 months. The Harris hip score at 6 months was 60 +/- 25 in Group A and 71 +/- 18 in Group B. The superior results of Group B can be attributed to the increased screw fixation provided by the HA-coated screws. We recommend lag screws coated with HA for dynamic hip screw fixation, especially in osteoporotic bone.
Department of Orthopaedic Surgery, Bologna University, Rizzoli Orthopaedic Institute, Via G.C. Pupilli 1, 40136 Bologna, Italy. a.moroni@ior.it
Antonio
A
Moroni
Cesare
C
Faldini
Francesco
F
Pegreffi
Sandro
S
Giannini
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001863:Bone Screws; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010024:Osteoporosis / Q000150:complications*; D011183:Postoperative Complications; D011859:Radiography; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D017886:Durapatite