title: Clinical and functional outcomes of the PCCP study: a multi-center prospective study in Italy.
abstract: The standard surgical management of hip fractures is associated with tissue trauma and bleeding which are added to the fracture injury. The percutaneous compression plate (PCCP) is a minimally invasive device that has been demonstrated in previous studies to reduce postoperative complications and blood loss. This prospective, multi-center, observational study assessed clinical and functional outcomes with PCCP as treatment for trochanteric fractures. Patients with a stable or unstable proximal femoral fracture of type AO 31.A1 or 31.A2 were enrolled in eight hospitals in Italy. The primary outcome of interest was the recovery of the pre-fracture functional status at 1-year follow-up; secondary outcomes of interest included blood transfusions, surgical time, complications, and mortality. A total of 273 patients were enrolled. The ASA score was 3 or 4 in 72.5 % of patients. The mean surgical time was 44.1 min; the mean post-surgery blood transfusions was 0.9 units. At 1 year, 48 patients (17.6 %) died, 28 (10.2 %) were lost to follow-up, 4 patients (1.5 %) were excluded, hence 193 patients (70.3 %) were available for final evaluation. At the 1-year follow-up visit, 51.9 % of patients recovered or improved their pre-fracture modified Harris Hip Score, 49.1 % of patients improved or maintained their walking abilities, and 66.6 % of patients residing at home pre-surgery maintained their domicile. The overall mortality rate was 17.6 %. Major complications included two fracture collapses, one excessive sliding of the cephalic screw leading to a partial fracture collapse and one back-out of the diaphyseal screw. This study demonstrates that treatment of trochanteric fractures with PCCP gives good outcomes and significant advantages such as low blood loss, short surgical time, low risk of complications, and good functional recovery in the majority of the patients.
authors.affiliation: Orthopaedic and Trauma Department, Azienda Ospedaliera San Carlo Borromeo, Via Pio II 3, 20153, Milan, Italy, md.guidoantonini@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Antonini
authors.forename: R
authors.initials: R
authors.lastname: Giancola
authors.forename: D
authors.initials: D
authors.lastname: Berruti
authors.forename: E
authors.initials: E
authors.lastname: Blanchietti
authors.forename: P
authors.initials: P
authors.lastname: Pecchia
authors.forename: V
authors.initials: V
authors.lastname: Francione
authors.forename: P
authors.initials: P
authors.lastname: Greco
authors.forename: T C
authors.initials: TC
authors.lastname: Russo
authors.forename: L
authors.initials: L
authors.lastname: Pietrogrande
references.citation: J Bone Joint Surg Br. 2002 Jan;84(1):19-22
references.pmid: 11837826
references.citation: J Clin Epidemiol. 2003 Aug;56(8):788-95
references.pmid: 12954472
references.citation: J Bone Joint Surg Br. 2007 Sep;89(9):1210-7
references.pmid: 17905960
references.citation: Aging (Milano). 2001 Apr;13(2):78-84
references.pmid: 11405389
references.citation: J Orthop Trauma. 2002 Jul;16(6):386-93
references.pmid: 12142826
references.citation: Orthopedics. 2002 Jun;25(6):647-52
references.pmid: 12083574
references.citation: J Orthop Trauma. 1997 Nov;11(8):594-9
references.pmid: 9415867
references.citation: J Bone Joint Surg Am. 2012 Mar 7;94(5):468-77
references.pmid: 22398742
references.citation: J Bone Joint Surg Am. 2008 Apr;90(4):700-7
references.pmid: 18381305
references.citation: Bull NYU Hosp Jt Dis. 2008;66(2):111-7
references.pmid: 18537780
references.citation: Injury. 2002 Jun;33(5):413-8
references.pmid: 12095721
references.citation: J Orthop Trauma. 2003 Jan;17(1):53-6
references.pmid: 12499968
references.citation: J Bone Joint Surg Br. 1991 Mar;73(2):330-4
references.pmid: 2005167
references.citation: Public Health. 2001 Sep;115(5):323-7
references.pmid: 11593441
references.citation: J Trauma. 2002 Feb;52(2):293-8
references.pmid: 11834991
references.citation: J Orthop Trauma. 1990;4(2):137-43
references.pmid: 2358927
references.citation: Orthopedics. 2008 Jan;31(1):29-36
references.pmid: 18269165
references.citation: Acta Orthop Belg. 2006 Jun;72(3):314-9
references.pmid: 16889143
references.citation: Aging Clin Exp Res. 2002 Oct;14(5):389-94
references.pmid: 12602574
references.citation: Rev Med Brux. 2004 Feb;25(1):40-6
references.pmid: 15053153
references.citation: Injury. 2005 Jun;36(6):793-800
references.pmid: 15910836
references.citation: J Orthop Surg Res. 2011 Jan 24;6:5
references.pmid: 21261942
references.citation: Injury. 2005 Nov;36(11):1343-9
references.pmid: 16214477
references.citation: Clin Orthop Relat Res. 1993 Sep;(294):187-92
references.pmid: 8358913
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Sep;55(9):M508-15
references.pmid: 10995048
references.citation: Strategies Trauma Limb Reconstr. 2008 Apr;3(1):15-22
references.pmid: 18427919
references.citation: N Engl J Med. 2000 Nov 23;343(21):1506-13
references.pmid: 11087879
references.citation: BMC Musculoskelet Disord. 2010 Jan 14;11:8
references.pmid: 20074324
references.citation: J Orthop Trauma. 2000 Sep-Oct;14(7):490-5
references.pmid: 11083611
references.citation: N Engl J Med. 1996 Jun 6;334(23):1519-25
references.pmid: 8618608
references.citation: J Bone Joint Surg Br. 1993 May;75(3):445-7
references.pmid: 8496218
references.citation: Ulster Med J. 2006 Sep;75(3):200-6
references.pmid: 16964812
references.citation: Acta Orthop Belg. 2008 Feb;74(1):38-48
references.pmid: 18411600
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Sep;55(9):M498-507
references.pmid: 10995047
references.citation: J Orthop Trauma. 1996;10 Suppl 1:v-ix, 1-154
references.pmid: 8814583
references.citation: Clin Orthop Relat Res. 2004 Aug;(425):82-6
references.pmid: 15292791
references.citation: ScientificWorldJournal. 2005 Mar 19;5:221-9
references.pmid: 15798882
references.citation: J Bone Joint Surg Br. 1993 Jan;75(1):6-13
references.pmid: 8421036
references.citation: Z Orthop Unfall. 2009 May-Jun;147(3):306-13
references.pmid: 19551581
references.citation: J Bone Joint Surg Am. 1969 Jun;51(4):737-55
references.pmid: 5783851
references.citation: J Orthop Trauma. 2001 Aug;15(6):394-400
references.pmid: 11514765
references.citation: Injury. 2008 Feb;39(2):244-8
references.pmid: 17953970
references.citation: Clin Orthop Relat Res. 2004 Aug;(425):64-71
references.pmid: 15292789