Tratamiento de las fracturas inestables intertrocantéricas. (Inglés)

Las complicaciones del implante relacionado con el tratamiento de las fracturas inestables intertrocantéricas: meta-análisis de la dinámica de tornillo-lámina frente a la del tornillo intramedular en los dispositivos del clavo.

Audige L, Hanson B, Swiontkowski MF.
AO Clinical Investigation and Documentation, AO ASIF Center, 7270 Davos Platz, Clavadelerstrasse, Switzerland.

The choice between dynamic screw-intramedullary nail (DSIN) devices and dynamic screw-plate (DSP) devices for the fixation of unstable trochanteric fractures remains controversial. This study presents a meta-analysis of fixation failures in unstable trochanteric femoral fractures using DSP devices or DSIN devices. Two independent assessors selected randomised controlled trials using a range of electronic databases, as well as reference lists of selected articles. A study quality checklist was used. The occurrence of fixation failure, in particular cut-out, was the primary subject of analysis using descriptive statistics and random-effect meta-analyses. Seventeen trials were identified. Meta-analyses showed no significant difference in the frequency of implant-related complications between the two types of devices. Iatrogenic femoral fractures associated with the use of DSIN devices represent a rare, but persistent, risk. There was a tendency for less frequent cut-out with intramedullary devices compared with DSP devices.

Int Orthop. 2003;27(4):197-203. Epub 2003 May 07.

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