The outcome of surgical treatment between minimal invasive technique and conventional technique in stable intertrochanteric fracture of femur by closed reduction and fixation with sliding hip screw/side plate (DHS) in Prapokklao Hospital,Chanthaburi.
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Abstract
Background : Closed reduction and fixation with sliding hip screw / side plate is standard operative treatment of stable intertrochanteric fracture of femur. The minimal invasive technique was first used at Prapokklao hospital about 5 years ago.However, clinical outcome of this surgical technique has never been evaluated.
Objective : To compare the outcome of treatment between 2 surgical technique
Method : Retrospectively evaluated all 171 patients with a stable intertrochanteric femur fracture who were treated between 2003 and 2007 with a sliding hip screw / side plate(DHS). The comparison between the two surgical technique was based on the surgical procedure (time, and total blood loss); the initial postoperative period (duration of hospital stay); complications and healing time.
Result : In total 47 MIS and 124 CON were DHS implanted . the mean operative time were 61.6 min (SD20) and 83.6 min (SD28) for MIS and CON p=0.000. The mean intraoperative blood loss were74 ml(SD96) and193 ml(SD146) p=0.000, the mean hospital stay were 9.93 day(SD2.9) and13.75 day(SD6.5) p = 0.000, and the mean healing time were53 day(SD18) and 86 day(SD36) p=0.000 no infected wound, bed ridden complication, obvious collapse, cut out and implant failure as comparison as conventional technique 3.2 percent, 3.5 percent, 8.3 percent, 1.2 percent, 2.7 percent
Conclusion : This study has shown the advantages of this mini-invasive technique; limited operative time, decreased blood loss, short hospital stay, short healing time and few complication. In a few years’ time, minimal invasive treatment may become the standard for elderly patients with intertrochanteric femur fractures.
Key words : minimal invasive technique, conventional technique, intertrochanteric fracture of femur, sliding hip screw with side plate