Trochanteric fixation using a third-generation cable device--minimum follow-up of 3 years

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Musculoskeletal Research

Background:

• Trochanteric fixation implants are crucial for hip fracture repair.
• Early implant generations faced challenges like breakage and nonunion.
• Third-generation cable systems aim to enhance stability and longevity.

Purpose of the Study:

• To prospectively evaluate the functional and radiologic outcomes of a third-generation trochanteric fixation cable system.
• To assess the efficacy of the Accord Cable Plate system in addressing complications of earlier implants.
• To determine the safety and performance of this novel implant in trochanteric fragment reattachment.

Main Methods:

• Prospective study involving 47 trochanteric fixations in 46 patients over 4 years.
• Utilized the Accord Cable Plate system (Smith and Nephew) across two institutions.
• Serial functional (Harris hip score, pain score) and radiologic evaluations were performed.

Main Results:

• Significant improvement in mean Harris hip scores from 52.3 to 88.2 (P < .001).
• Mean pain scores decreased from 6.2 to 2.3 (P < .001).
• No instances of cable breakage, fretting, or fraying were observed; 2 cases of nonunion occurred.

Conclusions:

• Third-generation trochanteric cable systems offer improved outcomes compared to earlier designs.
• The Accord Cable Plate system demonstrates favorable functional and radiologic results for trochanteric fragment fixation.
• This implant system shows promise for various clinical scenarios requiring trochanteric reattachment.