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Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures

PURPOSE: Dislocation is an important complication that increases the mortality, morbidity, and postoperative care following bipolar hemiarthroplasty. It is thought that the transtrochanteric approach that enables access to the femoral neck directly from the fracture line at the coronal plane of the...

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Autores principales: Gursoy, Safa, Simsek, Mehmet Emin, Akkaya, Mustafa, Dogan, Metin, Bozkurt, Murat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336027/
https://www.ncbi.nlm.nih.gov/pubmed/30666099
http://dx.doi.org/10.2147/CIA.S194880
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author Gursoy, Safa
Simsek, Mehmet Emin
Akkaya, Mustafa
Dogan, Metin
Bozkurt, Murat
author_facet Gursoy, Safa
Simsek, Mehmet Emin
Akkaya, Mustafa
Dogan, Metin
Bozkurt, Murat
author_sort Gursoy, Safa
collection PubMed
description PURPOSE: Dislocation is an important complication that increases the mortality, morbidity, and postoperative care following bipolar hemiarthroplasty. It is thought that the transtrochanteric approach that enables access to the femoral neck directly from the fracture line at the coronal plane of the greater trochanter without opening the posterior and anterior capsules could reduce the risk of dislocation. Additionally, it is argued that preservation of the external rotators could also be advantageous for patient rehabilitation and muscle strength. The aim of this study is to compare the effectiveness of the standard posterolateral approach and transtrochanteric approach performed from the fracture line, primarily the rate of dislocation, in osteoporotic Evans Type IV–V unstable intertrochanteric fractures on which bipolar hemiarthroplasty was performed. PATIENTS AND METHOD: One hundred and twelve patients had Type IV–V fracture according to Evans classification and underwent hemiarthroplasty were enrolled in the study. Patients operated using the posterolateral approach, that is, Group 1 (n=48), and patients operated using the transtrochanteric (transfracture) approach, that is, Group 2 (n=64), were compared in terms of dislocation, surgical duration, amount of blood transfusion, infection, mortality, and trochanteric nonunion. Factors that could affect the development of dislocation from the patient, surgery, and implant were also analyzed. RESULTS: It was found that the rate of dislocation was statistically significantly higher in Group 1 in comparison to Group 2 (P<0.05). It was also observed that the surgical duration was statistically significantly shorter in Group 2 (P<0.05). It was found that the presence of a cognitive disorder, trochanteric nonunion, and use of posterolateral surgical approach resulted in a statistically significant increase in the rate of dislocation (P<0.05). CONCLUSION: Transtrochanteric (transfracture) approach is an effective method for minimizing possible complications following hemiarthroplasty, especially dislocation.
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spelling pubmed-63360272019-01-21 Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures Gursoy, Safa Simsek, Mehmet Emin Akkaya, Mustafa Dogan, Metin Bozkurt, Murat Clin Interv Aging Original Research PURPOSE: Dislocation is an important complication that increases the mortality, morbidity, and postoperative care following bipolar hemiarthroplasty. It is thought that the transtrochanteric approach that enables access to the femoral neck directly from the fracture line at the coronal plane of the greater trochanter without opening the posterior and anterior capsules could reduce the risk of dislocation. Additionally, it is argued that preservation of the external rotators could also be advantageous for patient rehabilitation and muscle strength. The aim of this study is to compare the effectiveness of the standard posterolateral approach and transtrochanteric approach performed from the fracture line, primarily the rate of dislocation, in osteoporotic Evans Type IV–V unstable intertrochanteric fractures on which bipolar hemiarthroplasty was performed. PATIENTS AND METHOD: One hundred and twelve patients had Type IV–V fracture according to Evans classification and underwent hemiarthroplasty were enrolled in the study. Patients operated using the posterolateral approach, that is, Group 1 (n=48), and patients operated using the transtrochanteric (transfracture) approach, that is, Group 2 (n=64), were compared in terms of dislocation, surgical duration, amount of blood transfusion, infection, mortality, and trochanteric nonunion. Factors that could affect the development of dislocation from the patient, surgery, and implant were also analyzed. RESULTS: It was found that the rate of dislocation was statistically significantly higher in Group 1 in comparison to Group 2 (P<0.05). It was also observed that the surgical duration was statistically significantly shorter in Group 2 (P<0.05). It was found that the presence of a cognitive disorder, trochanteric nonunion, and use of posterolateral surgical approach resulted in a statistically significant increase in the rate of dislocation (P<0.05). CONCLUSION: Transtrochanteric (transfracture) approach is an effective method for minimizing possible complications following hemiarthroplasty, especially dislocation. Dove Medical Press 2019-01-14 /pmc/articles/PMC6336027/ /pubmed/30666099 http://dx.doi.org/10.2147/CIA.S194880 Text en © 2019 Gursoy et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Gursoy, Safa
Simsek, Mehmet Emin
Akkaya, Mustafa
Dogan, Metin
Bozkurt, Murat
Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title_full Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title_fullStr Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title_full_unstemmed Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title_short Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
title_sort transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336027/
https://www.ncbi.nlm.nih.gov/pubmed/30666099
http://dx.doi.org/10.2147/CIA.S194880
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