[Proximal cut-out of the hip screw: cement augmentation as a minimally invasive rescue procedure].
BACKGROUND
Cemented augmentation of osteosynthesis for the treatment of peritrochanteric fractures in elderly patients has been under discussion for years. We propose this option as a salvage procedure in cases of instability after standard osteosynthesis.


METHODS
After reduction and optional re-osteosynthesis a Jamshidi needle is placed transcutanously or through the open wound cranio-lateral of the tip of the hip screw. Cement augmentation can be performed under fluoroscopic control. The patients were monitored for at least 7 months postoperatively to rule out a redislocation.


RESULTS
From 1/2009 to 1/2011 we treated 6 patients (5 female, 1 male, age 83.8 [79-94] years). We performed 4 augmentations and 2 augmentations with additional re-osteosynthesis. OP time was 26.8 (13-45) minutes. The revision was performed 9.7 (4-14) days after the osteosynthesis. Within 14.7 (7-28) months no redislocation and no surgical complication occurred.


CONCLUSIONS
Even with a small patient number the good results show the potential of this minimally invasive technique. In our opinion this option allows a fast and technically easy salvage procedure without blocking of further treatment options like a prosthesis.
Orthopädie und Unfallchirurgie, Klinikum Duisburg, Klinik der Sana-Gruppe. dr.med.ackermann@gmx.de
O
O
Ackermann
M
M
Stanjek
C
C
Rülander
C
C
von Schulze Pellengahr
D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D060826:Cementoplasty / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome