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Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems

Extracapsular hip fractures are very common in the elderly. They are mainly treated surgically with an intramedullary nail. Nowadays, both endomedullary hip nails with single cephalic screw systems and interlocking double screw systems are available on the market. The latter are supposed to increase...

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Autores principales: Méndez-Ojeda, Marye M., Herrera-Rodríguez, Alejandro, Álvarez-Benito, Nuria, González-Pacheco, Himar, García-Bello, Miguel A., Álvarez-de la Cruz, Javier, Pais-Brito, José L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219306/
https://www.ncbi.nlm.nih.gov/pubmed/37240518
http://dx.doi.org/10.3390/jcm12103411
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author Méndez-Ojeda, Marye M.
Herrera-Rodríguez, Alejandro
Álvarez-Benito, Nuria
González-Pacheco, Himar
García-Bello, Miguel A.
Álvarez-de la Cruz, Javier
Pais-Brito, José L.
author_facet Méndez-Ojeda, Marye M.
Herrera-Rodríguez, Alejandro
Álvarez-Benito, Nuria
González-Pacheco, Himar
García-Bello, Miguel A.
Álvarez-de la Cruz, Javier
Pais-Brito, José L.
author_sort Méndez-Ojeda, Marye M.
collection PubMed
description Extracapsular hip fractures are very common in the elderly. They are mainly treated surgically with an intramedullary nail. Nowadays, both endomedullary hip nails with single cephalic screw systems and interlocking double screw systems are available on the market. The latter are supposed to increase rotational stability and therefore decrease the risk of collapse and cut-out. A retrospective cohort study was carried out, in which 387 patients with extracapsular hip fracture undergoing internal fixation with an intramedullary nail were included to study the occurrence of complications and reoperations. Of the 387 patients, 69% received a single head screw nail and 31% received a dual integrated compression screw nail. The median follow-up was 1.1 years, and in that time, a total of 17 reoperations were performed (4.2%; 2.1% for single head screw nails vs. 8.7% for double head screws). According to the multivariate logistic regression model adjusted for age, sex and basicervical fracture, the adjusted hazard risk of reoperation required was 3.6 times greater when using double interlocking screw systems (p = 0.017). A propensity scores analysis confirmed this finding. In conclusion, despite the potential benefits of using two interlocking head screw systems and the increased risk of reoperation in our single center, we encourage to other researchers to explore this question in a wider multicenter study.
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spelling pubmed-102193062023-05-27 Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems Méndez-Ojeda, Marye M. Herrera-Rodríguez, Alejandro Álvarez-Benito, Nuria González-Pacheco, Himar García-Bello, Miguel A. Álvarez-de la Cruz, Javier Pais-Brito, José L. J Clin Med Article Extracapsular hip fractures are very common in the elderly. They are mainly treated surgically with an intramedullary nail. Nowadays, both endomedullary hip nails with single cephalic screw systems and interlocking double screw systems are available on the market. The latter are supposed to increase rotational stability and therefore decrease the risk of collapse and cut-out. A retrospective cohort study was carried out, in which 387 patients with extracapsular hip fracture undergoing internal fixation with an intramedullary nail were included to study the occurrence of complications and reoperations. Of the 387 patients, 69% received a single head screw nail and 31% received a dual integrated compression screw nail. The median follow-up was 1.1 years, and in that time, a total of 17 reoperations were performed (4.2%; 2.1% for single head screw nails vs. 8.7% for double head screws). According to the multivariate logistic regression model adjusted for age, sex and basicervical fracture, the adjusted hazard risk of reoperation required was 3.6 times greater when using double interlocking screw systems (p = 0.017). A propensity scores analysis confirmed this finding. In conclusion, despite the potential benefits of using two interlocking head screw systems and the increased risk of reoperation in our single center, we encourage to other researchers to explore this question in a wider multicenter study. MDPI 2023-05-11 /pmc/articles/PMC10219306/ /pubmed/37240518 http://dx.doi.org/10.3390/jcm12103411 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Méndez-Ojeda, Marye M.
Herrera-Rodríguez, Alejandro
Álvarez-Benito, Nuria
González-Pacheco, Himar
García-Bello, Miguel A.
Álvarez-de la Cruz, Javier
Pais-Brito, José L.
Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title_full Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title_fullStr Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title_full_unstemmed Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title_short Treatment of Trochanteric Hip Fractures with Cephalomedullary Nails: Single Head Screw vs. Dual Integrated Compression Screw Systems
title_sort treatment of trochanteric hip fractures with cephalomedullary nails: single head screw vs. dual integrated compression screw systems
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219306/
https://www.ncbi.nlm.nih.gov/pubmed/37240518
http://dx.doi.org/10.3390/jcm12103411
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