Dataset Information

No benefit of the trochanteric stabilizing plate on loss of fracture reduction in AO/OTA 31-A2 trochanteric fractures.

ABSTRACT:

Aims

Despite limited clinical scientific backing, an additional trochanteric stabilizing plate (TSP) has been advocated when treating unstable trochanteric fractures with a sliding hip screw (SHS). We aimed to explore whether the TSP would result in less post operative fracture motion, compared to SHS alone.

Methods

Overall, 31 patients with AO/OTA 31-A2 trochanteric fractures were randomized to either a SHS alone or a SHS with an additional TSP. To compare postoperative fracture motion, radiostereometric analysis (RSA) was performed before and after weightbearing, and then at four, eight, 12, 26, and 52 weeks. With the "after weightbearing" images as baseline, we calculated translations and rotations, including shortening and medialization of the femoral shaft.

Results

Similar migration profiles were observed in all directions during the course of healing. At one year, eight patients in the SHS group and 12 patients in the TSP group were available for analysis, finding a clinically non-relevant, and statistically non-significant, difference in total translation of 1 mm (95% confidence interval -4.7 to 2.9) in favour of the TSP group. In line with the migration data, no significant differences in clinical outcomes were found.

Conclusion

The TSP did not influence the course of healing or postoperative fracture motion compared to SHS alone. Based on our results, routine use of the TSP in AO/OTA 31-A2 trochanteric fractures cannot be recommended. The TSP has been shown, in biomechanical studies, to increase stability in sliding hip screw constructs in both unstable and intermediate stable trochanteric fractures, but the clinical evidence is limited. This study showed no advantage of the TSP in unstable (AO 31-A2) fractures in elderly patients when fracture movement was evaluated with radiostereometric analysis.

SUBMITTER: Alm CE

PROVIDER: S-EPMC10797560 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

No benefit of the trochanteric stabilizing plate on loss of fracture reduction in AO/OTA 31-A2 trochanteric fractures.

Alm Carl E CE Karlsten Anders A Madsen Jan E JE Nordsletten Lars L Brattgjerd Jan E JE Pripp Are H AH Frihagen Frede F Röhrl Stephan M SM

Bone & joint open 20240119 1

<h4>Aims</h4>Despite limited clinical scientific backing, an additional trochanteric stabilizing plate (TSP) has been advocated when treating unstable trochanteric fractures with a sliding hip screw (SHS). We aimed to explore whether the TSP would result in less post operative fracture motion, compared to SHS alone.<h4>Methods</h4>Overall, 31 patients with AO/OTA 31-A2 trochanteric fractures were randomized to either a SHS alone or a SHS with an additional TSP. To compare postoperative fracture ...[more]

PMID: 38240179

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Dataset Information

No benefit of the trochanteric stabilizing plate on loss of fracture reduction in AO/OTA 31-A2 trochanteric fractures.

Aims

Methods

Results

Conclusion

Publications

No benefit of the trochanteric stabilizing plate on loss of fracture reduction in AO/OTA 31-A2 trochanteric fractures.

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