Tornillo dinámico percutáneo de la cadera

T.S. Waters, a, , D.M.R. Gibbsa, J.H. Dorrella and D.P. Powlesa

aDepartment of Orthopaedics, The Lister Hospital, Stevenage, Hertfordshire, UK

Accepted 6 March 2006. Available online 12 June 2006.

Summary

We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2–2.5 cm.

The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex-matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre- and post-operative haemoglobin concentration, haematocrit and prevalence of wound infection.

Thirteen consecutive cases were performed by one surgeon using the percutaneous technique. There were nine females and four males with a mean age of 84 years (range 62–96 years). Each had a 135° four-hole plate.

The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0–4.4 g/dl) compared to 3.5 g/dl (range 1.2–5.4 g/dl) in the control group (p = 0.014). The mean haematocrit drop was 0.07 (range 0–0.12) in the percutaneous group compared to 0.10 (range 0.03–0.17) in the control group (p = 0.017).

The mean theatre time with the percutaneous technique was 57 min (range 40–75 min) and in the control group, 60 min (range 30–95 min). There were no wound problems.

It is likely that this minimally invasive technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study.

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