Observational studyBMC musculoskeletal disorders2017
Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.
Observational study in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 13 citations in OpenAlex.
- Minimally invasive reduction of irreducible, sagittally unstable peritrochanteric fractures: Novel technique and early results.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Implant Design and Its Applications in the Fixation of Osteoporotic Bones: Newer Technologies in Nails, Plates and External Fixators.Indian journal of orthopaedics · 2025Review
- Torsional stability of fixation methods in basicervical femoral neck fractures: a biomechanical study.Journal of orthopaedic surgery and research · 2024Article
- Benefit of lag screw placement by a single- or two-screw nailing system in elderly patients with AO/OTA 31-A2 trochanteric fractures.The Journal of international medical research · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database.
methodsAll consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications.
resultsThe relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%.
conclusionsThe treatment protocol based on use of biaxial Medoff sliding plate for unstable pertrochanteric and uniaxial Medoff sliding plate for subtrochanteric fractures reduced the risk of severe technical complications compared to using the treatment protocol based on dynamic hip screw and intramedullary nail.
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