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Related Experiment Videos

Extramedullary fixation implants for extracapsular hip fractures.

M J Parker1, H H Handoll

  • 1Orthopaedic Department, Peterborough District Hospital, Thorpe Road, Peterborough, Cambridgeshire, UK, PE3 6DA. mjparker@doctors.org.uk

The Cochrane Database of Systematic Reviews
|June 22, 2002
PubMed
Summary

The sliding hip screw (SHS) shows lower risks of implant breakage and fixation failure compared to fixed nail plates for hip fractures. Evidence is insufficient to definitively compare SHS with other extramedullary implants.

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Biomaterials Science

Background:

  • Extramedullary fixation involves applying plates and screws to the proximal femur for hip fracture treatment.
  • Extracapsular hip fractures are common injuries requiring surgical intervention.

Purpose of the Study:

  • To compare the efficacy and safety of various extramedullary fixation implants for adult extracapsular hip fractures.
  • To evaluate implant performance based on fixation failure, complications, and anatomical restoration.

Main Methods:

  • Systematic review of randomized and quasi-randomized controlled trials.
  • Searched Cochrane Musculoskeletal Injuries Group register and relevant literature up to October 2001.
  • Assessed trial quality and extracted data independently; pooled data where appropriate.

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Main Results:

  • Fixed nail plates demonstrated a higher risk of fixation failure compared to the sliding hip screw (SHS).
  • Contrasting results were observed when comparing the RAB plate with the SHS regarding complications and restoration.
  • The Medoff plate showed a lower fixation failure rate for unstable trochanteric fractures but similar outcomes for other fracture types.

Conclusions:

  • The SHS is preferable due to lower risks of implant breakage and fixation failure compared to fixed nail plates.
  • Insufficient evidence exists to draw firm conclusions on the clinical significance of differences between SHS and other implants (RAB, Pugh, Medoff).