الفهرس | Only 14 pages are availabe for public view |
Abstract The rigid fixation of greater trochanter has been supported by more and more surgeons, but the choice of fixation is still controversial. Traditional wires are widely used because of its relatively simple procedure and low cost. But the high failure rates also led orthopedists to seek for other more effective fixation methods. In recent years, the appearance of locking plates has provided better stability for fracture fixation. These plates are widely used in various places of the human body, so some surgeons began to use locking plates to fix the greater trochanter fragment during hip arthroplasty surgeries. Compared with the conventional compressing plates, locking plates with uni-cortical screws can provide enough stability for fracture site. The aim of study was to compare between methods of fixation of greater trochanter during hip arthroplasty according to type and postoperative outcome. This review was on Non randomized and randomized controlled trials, prospective and retrospective studies which compare different methods of fixation of trochanter during hip arthroplasty. The search strategy identified 220 unique citations. Screening of titles and abstracts identified 90 potentially relevant articles. Full text review of these articles identified 10 studies meeting the inclusion criteria. 8 were retrospective and 2 prospective studies. Summary __________________________________________________________ 38 The main results of the study revealed that: A total of 474 patients were included with M\F: 169\305 and mean age: 69.13 years Mean follow up period was 40 months, min-max 6 -80.4 Claw Plate in 2 studies, hook plate in 3 study, Cable Plate in 2 studies, K-wires in 2 studies and intra-osseus sutures in 1 study 398 cases showed complete union and nonunion was founded in 76 cases Mean HARRIS hip before was 48.9 which increased to 83.1 after treatment Regarding restored the abductor function, mentioned in 2 studies and was in 88 cases. Mean VAS pre was 7.1 which decreased to 3.2 post operation A total of 198 complications were founded in form of A total of 198 complications were founded in form of broken cable (1), Limping (60), Nonunion (76), Symptomatic trochanteric bursitis (2), Pain (63). 10 studies were included mentioned union rate shows highly significant differences between included studies p-value< 0.001, I2 (inconsistency) 98.26% and 95% CI for I2 was 97.69 – 98.69 10 studies were included mentioned nonunion rate shows highly significant differences between included studies pvalue< 0.001, I2 (inconsistency) 75.12% and 95% CI for I2 was 53.64 – 86.64 Summary __________________________________________________________ 39 10 studies were included mentioned complications shows highly significant differences between included studies pvalue< 0.001, I2 (inconsistency) 95.03% and 95% CI for I2 was 92.62 – 96.65 Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion. |