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[Proximal cut-out of the hip screw: cement augmentation as a minimally invasive rescue procedure]
O Ackermann1, M Stanjek, C Rülander
1Orthopädie und Unfallchirurgie, Klinikum Duisburg, Klinik der Sana-Gruppe. dr.med.ackermann@gmx.de
Background:
Cemented augmentation of osteosynthesis for the treatment of peritrochanteric fractures in elderly patients has been under discussion for years. We propose this option as a salvage procedure in cases of instability after standard osteosynthesis.
Material And Methods:
After reduction and optional re-osteosynthesis a Jamshidi needle is placed transcutanously or through the open wound cranio-lateral of the tip of the hip screw. Cement augmentation can be performed under fluoroscopic control. The patients were monitored for at least 7 months postoperatively to rule out a redislocation.
Results:
From 1/2009 to 1/2011 we treated 6 patients (5 female, 1 male, age 83.8 [79-94] years). We performed 4 augmentations and 2 augmentations with additional re-osteosynthesis. OP time was 26.8 (13-45) minutes. The revision was performed 9.7 (4-14) days after the osteosynthesis. Within 14.7 (7-28) months no redislocation and no surgical complication occurred.
Conclusion:
Even with a small patient number the good results show the potential of this minimally invasive technique. In our opinion this option allows a fast and technically easy salvage procedure without blocking of further treatment options like a prosthesis.
