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Extramedullary fixation of 569 unstable intertrochanteric fractures: a randomized multicenter trial of the Medoff sliding plate versus three other screw-plate systems

Lunsjö, Karl; Ceder, Leif; Thorngren, Karl-Göran LU ; Skytting, Björn; Tidermark, Jan; Berntson, Per-Olof; Allvin, Ingemar; Norberg, Sigge; Hjalmars, Krister and Larsson, Sune, et al. (2001) In Acta Orthopaedica Scandinavica 72(2). p.133-140
Abstract
We compared the efficacy of the Medoff sliding plate (MSP) with 3 other screw-plate systems for fixation of unstable intertrochanteric fractures in a randomized multicenter trial of 569 elderly patients. The MSP has biaxial dynamic capacity along both the neck and the shaft of the femur unlike the other systems, which lack dynamic capacity along the shaft. 268 fractures were operated on with the MSP, and 301 with the dynamic hip screw (DHS), with or without a trochanteric stabilizing plate (DHS/TSP) or with the dynamic condylar screw (DCS). The MSP had recently been shown to the surgeons.The patients in the groups were similar as regards age, domestic situation, preinjury walking ability and type of fracture. We followed the patients... (More)
We compared the efficacy of the Medoff sliding plate (MSP) with 3 other screw-plate systems for fixation of unstable intertrochanteric fractures in a randomized multicenter trial of 569 elderly patients. The MSP has biaxial dynamic capacity along both the neck and the shaft of the femur unlike the other systems, which lack dynamic capacity along the shaft. 268 fractures were operated on with the MSP, and 301 with the dynamic hip screw (DHS), with or without a trochanteric stabilizing plate (DHS/TSP) or with the dynamic condylar screw (DCS). The MSP had recently been shown to the surgeons.The patients in the groups were similar as regards age, domestic situation, preinjury walking ability and type of fracture. We followed the patients clinically and radiographically for at least 1 year. There was no significant difference in walking ability at follow-up or rate of return to home. Fixation failure occurred in 18/268 fractures operated on with the MSP, in 8/238 with the DHS, in 3/49 with the DHS/TSP and in 1/14 with the DCS. The difference in the rate of fixation failure was not statistically significant when the MSP group was compared to the 3 other groups. In 14 of the 18 fixation failures in the MSP group, the biaxial dynamic capacity of the MSP had not been used due to technical errors by surgeons, unfamiliar with the new method. No selection bias was found regarding fracture types in the 2 subgroups of patients with correct or inadequate biaxial dynamization. Extramedullary fixation of unstable intertrochanteric fractures with these implants showed a low failure rate. When using the MSP, biaxial dynamization must be correctly performed. (Less)
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Acta Orthopaedica Scandinavica
volume
72
issue
2
pages
133 - 140
publisher
Taylor & Francis
external identifiers
  • pmid:11372943
  • scopus:17744389598
ISSN
0001-6470
DOI
10.1080/000164701317323372
language
English
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yes
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d4da6313-fd8b-420d-b4d8-fb62bf2e01a4 (old id 1121383)
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2008-07-04 12:19:38
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2018-07-15 04:14:21
@article{d4da6313-fd8b-420d-b4d8-fb62bf2e01a4,
  abstract     = {We compared the efficacy of the Medoff sliding plate (MSP) with 3 other screw-plate systems for fixation of unstable intertrochanteric fractures in a randomized multicenter trial of 569 elderly patients. The MSP has biaxial dynamic capacity along both the neck and the shaft of the femur unlike the other systems, which lack dynamic capacity along the shaft. 268 fractures were operated on with the MSP, and 301 with the dynamic hip screw (DHS), with or without a trochanteric stabilizing plate (DHS/TSP) or with the dynamic condylar screw (DCS). The MSP had recently been shown to the surgeons.The patients in the groups were similar as regards age, domestic situation, preinjury walking ability and type of fracture. We followed the patients clinically and radiographically for at least 1 year. There was no significant difference in walking ability at follow-up or rate of return to home. Fixation failure occurred in 18/268 fractures operated on with the MSP, in 8/238 with the DHS, in 3/49 with the DHS/TSP and in 1/14 with the DCS. The difference in the rate of fixation failure was not statistically significant when the MSP group was compared to the 3 other groups. In 14 of the 18 fixation failures in the MSP group, the biaxial dynamic capacity of the MSP had not been used due to technical errors by surgeons, unfamiliar with the new method. No selection bias was found regarding fracture types in the 2 subgroups of patients with correct or inadequate biaxial dynamization. Extramedullary fixation of unstable intertrochanteric fractures with these implants showed a low failure rate. When using the MSP, biaxial dynamization must be correctly performed.},
  author       = {Lunsjö, Karl and Ceder, Leif and Thorngren, Karl-Göran and Skytting, Björn and Tidermark, Jan and Berntson, Per-Olof and Allvin, Ingemar and Norberg, Sigge and Hjalmars, Krister and Larsson, Sune and Knebel, Richard and Hauggaard, Anders and Stigsson, Leif},
  issn         = {0001-6470},
  language     = {eng},
  number       = {2},
  pages        = {133--140},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica Scandinavica},
  title        = {Extramedullary fixation of 569 unstable intertrochanteric fractures: a randomized multicenter trial of the Medoff sliding plate versus three other screw-plate systems},
  url          = {http://dx.doi.org/10.1080/000164701317323372},
  volume       = {72},
  year         = {2001},
}