Initial promising results of the dynamic locking blade plate, a new implant for the fixation of intracapsular hip fractures: results of a pilot study.
BACKGROUND
The osteosynthesis of intracapsular hip fractures results in a 19-48% failure rate. Only when the anatomical reduction is secured by stable fixation, revascularisation of the femoral head can take place and the fracture can heal by primary osteonal reconstruction. The common implants lack rotational and/or angular stability. Also the relative large volume of the implants within the femoral head compromises the (re)vascularisation. The combination of an anatomical reduction and a low volume, dynamic implant, providing angular and rotational stability seem to be crucial factors in the treatment of intracapsular hip fractures. This assumption formed the starting point for the development of the dynamic locking blade plate (DLBP), a new implant for the internal fixation of intracapsular hip fractures. This report describes the first clinical results of the new implant.


METHODS
Internal fixation with the DLBP was performed in 25 consecutive patients with an intracapsular hip fracture within 24 h from admission. Failure of fixation, due to non-union, avascular necrosis, implant failure or secondary displacement of the fracture, was the primary outcome measurer. Functional outcome was assessed by the Harris Hip Score.


RESULTS
Following internal fixation of intracapsular hip fractures with the DLBP, a failure rate of 2 out of 25 patients and excellent functional results were seen after a follow-up of more than 2 years.


CONCLUSIONS
The initial clinical results of the DLBP are promising and justify the start of a randomised controlled trial.
Department of Traumatology, Medisch Spectrum Twente, PO BOX 50.000, 7500 KA Enschede, The Netherlands. roerdink.bouman@wxs.nl
W H
WH
Roerdink
A M M
AM
Aalsma
G
G
Nijenbanning
A D P
AD
van Walsum
D000328:Adult; D000368:Aged; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011859:Radiography; D053441:Suture Anchors; D016896:Treatment Outcome