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.
We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 22.5 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 6296 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 04.4 g/dl) compared to 3.5 g/dl (range 1.25.4 g/dl) in the control group (p = 0.014). The mean haematocrit drop was 0.07 (range 00.12) in the percutaneous group compared to 0.10 (range 0.030.17) in the control group (p = 0.017).
The mean theatre time with the percutaneous technique was 57 min (range 4075 min) and in the control group, 60 min (range 3095 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.