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Minimally invasive dynamic hip screw for fixation of hip fractures

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Abstract

We compared a minimally invasive surgical technique to the conventional (open approach) surgical technique used in fixation of hip fractures with the dynamic hip screw (DHS) device. Using a case-control design (44 cases and 44 controls), we tested the null hypothesis that there is no difference between the two techniques in the following outcome measures: duration of surgery, time to mobilisation and weight bearing postoperatively, length of hospital stay, mean difference of pre- and postoperative haemoglobin levels, position of the lag screw of the DHS device in the femoral head, and the tip–apex distance. The minimally invasive DHS technique had significantly shorter duration of surgery and length of hospital stay. There was also less blood loss in the minimally invasive DHS technique. The minimally invasive DHS technique produces better outcome measures in the operating time, length of hospital stay, and blood loss compared to the conventional approach while maintaining equal fixation stability.

Résumé

Ce travail a pour but de comparer les techniques de fixation de fractures de la hanche par voie mini-invasive ou par voie d’abord conventionnelle avec utilisation de matériel de type DHS. Nous avons pour cette étude regroupé les patients en deux groupes, 44 cas par voie mini-invasive et 44 cas contrôle. Nous avons voulu tester l’hypothèse suivante: existe-t-il une différence entre ces deux techniques, sur la durée d’intervention, de reprise de l’appui post-opératoire; de durée moyenne de séjour des pertes sanguines notamment et enfin, en ce qui concerne la position de la vis céphalique dans la tête fémorale et sa distance par rapport à l’interligne. La technique mini-invasive entraîne de façon significative un temps chirurgical diminué et une diminution de la durée moyenne de séjour. Ceci est également vrai pour les pertes sanguines. Cette technique est pour nous supérieure en ce qui concerne ces items si on la compare à l’abord de type conventionnel en sachant que les problèmes de stabilité du matériel sont identiques quelle que soit la technique utilisée.

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Acknowledgements

Dr Ho completed this investigation as part of his requirement of his Research Module in Trauma and Orthopaedics. Dr Garau was recipient of a Research Studentship from the Societa’ Italiana di Ortopedia e Traumatologia (SIOT).

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Authors and Affiliations

  1. Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke on Trent, ST4 7QB, UK

    Michael Ho, Gayle Walley & Nicola Maffulli

  2. Department of Trauma and Orthopaedic Surgery, University of Cagliari, Cagliari, Italy

    Giorgio Garau

  3. Department of Orthopaedics, Universita’ di Roma Tor Vergata, Rome, Italy

    Francesco Oliva

  4. Dipartimento di Scienze della Salute, Università del Molise, Campobasso, Italy

    Alfredo Schiavone Panni

  5. Department of Orthopaedics, Campus Biomedico, Rome, Italy

    Umile Giuseppe Longo

Authors
  1. Michael Ho
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  2. Giorgio Garau
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  3. Gayle Walley
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  4. Francesco Oliva
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  5. Alfredo Schiavone Panni
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  6. Umile Giuseppe Longo
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  7. Nicola Maffulli
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Corresponding author

Correspondence to Nicola Maffulli.

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Ho, M., Garau, G., Walley, G. et al. Minimally invasive dynamic hip screw for fixation of hip fractures. International Orthopaedics (SICOT) 33, 555–560 (2009). https://doi.org/10.1007/s00264-008-0565-4

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  • DOI: https://doi.org/10.1007/s00264-008-0565-4

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