[Comparison of the Ender's nailing and Dynamic Hip Screw (DHS) fixation in the treatment of trochanteric fractures in elderly patients].
The aim of this study was an evaluation which operative method of treatment: stabilisation with the Dynamic Hip Screw or with Ender's nails is less invasive procedure in elderly patients with trochanteric fractures. 100 consecutive patients with trochanteric fracture were enrolled into the study, of which 53 patients (49 women, 4 men; mean age 89 years) were stabilised intramedullarily with the use of Ender's nails and 47 patients (26 women, 21 men; mean age 76 years) were treated operatively with the use of Dynamic Hip Screw. The factors compared the mean length of hospital stay, the mean duration of the surgery, post-operative blood loss, early local and general complication rate and mortality in both groups. We took into account their general health and coexisting illnesses according to the American Society of Anesthesiologists (ASA) classification, type of fracture according to AO and Evan's classifications and the surgeon's experience. The mean duration of the surgery was 27 minutes longer in the case of DHS stabilisation. The complication rate was higher and the mean length of postoperative hospital stay was longer after Ender nailing. The mean blood loss: the drop in Red Blood Cells (RBC), Haematocrit (Ht) and the Mean Haemoglobin Concentration (Hb) was also higher in patients treated with the use of Ender nails. The mean rate of blood units that had to be transfused postoperatively was also higher in "Ender" group. The difference was statistically significant, especially in the group of patients treated as emergency procedure at the day of admission (p < 0.05). The operative treatment of trochanteric fractures in elderly patients with the use of DHS device showed to be a less invasive procedure in comparison to Ender nailing. In conclusion, the indications for this method of trochanteric fractures' treatment should be expanded, especially in the case of unstable fractures.
Sliwka
Andrzej
A
Katedra Klinika Ortopedii i Traumatologii Narzadu Ruchu, Akademia Medyczna w Warszawie.
Zgoda
Marcin
M
Górski
Radosław
R
Purski
Karol
K
Wasilewski
Piotr
P
Górecki
Andrzej
A
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012720:Severity of Illness Index; D016896:Treatment Outcome