Tratamiento quirúrgico de las fracturas intertrocantéricas del fémur con placa tornillo dinámico convencional comparado con tornillo dinámico helicoidal
Thesis
Introduction:Intertrochanteric fractures have a higher incidence nowadays, mainly due to aging population, who are suffering fractures more complex, less stable and associated with osteoporosis. It is estimated that this type of fractures represents approximately 1.75 million years of lost life adjusted to disability, equal to 0.1% of the burden disease worldwide. There is a consensus in the surgical treatment for these fractures, which come up with a variable incidence of failures, especially when they are unstable, as in the case of the ones called cut out. The usage of the method of fixation with plate and helical screw (DHHS) apparently decreases the incidence of such failures with respect to other techniques.Methodology:Using a calculated sample size of 128 patients with intertrochanteric fractures operated with DHS and DHHS from 2007 to 2012 at San Rafael Medical Clinic (Bogota, Colombia), a multivariate analysis was performed to determine if there are or there are not significant failure rates differences between these two techniques.Results:Patients included in this study were 54 (42.1%) male and 74 (57.8%) women. 75 were operated with DHHS and 53 with DHS. Main comorbidities were: Hypertension with 40 patients for DHS and 30 for DHHS; and, Diabetes Mellitus with 13 and 9 for DHS and DHHS respectively. The most common type of fracture in Tronzo’s classification was type 2 with 9 patients for DHS and 13 for DHHS.Conclusion:For the three main outcomes evaluated: 1. Percentage of reoperation (p=0,282) , 2. Survival during the first year (p=0,499) and 3. Functional performance according to Oxford’s scale (p=0,06), study shows there were no statistically significant differences between groups.
