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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 9, 1203-1209.
doi: 10.1302/0301-620X.87B9.15792  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Resorbable cement for the augmentation of internally-fixed unstable trochanteric fractures

A PROSPECTIVE, RANDOMISED MULTICENTRE STUDY

P. Mattsson, MD, Orthopaedic Surgeon1; A. Alberts, MD, PhD, Consultant Orthopaedic Surgeon2; G. Dahlberg, MD, Consultant Orthopaedic Surgeon3; M. Sohlman, MD, Orthopaedic Surgeon2; H. C. Hyldahl, MD, PhD, Consultant Orthopaedic Surgeon3; and S. Larsson, PhD, MD, Professor1

1 Department of Orthopaedics, Uppsala University Hospital, S-75185 Uppsala, Sweden.
2 Department of Orthopaedics, Karolinska University, Hospital, S-17176, Stockholm, Sweden.
3 Department of Orthopaedics, St Göran Hospital, Stockholm, Sweden

Correspondence should be sent to Professor S. Larsson; e-mail: sune.larsson{at}ortopedi.uu.se

We undertook a multicentre, prospective study of a series of 112 unstable trochanteric fractures in order to evaluate if internal fixation with a sliding screw device combined with augmentation using a calcium phosphate degradable cement (Norian SRS) could improve the clinical, functional and radiological outcome when compared with fractures treated with a sliding screw device alone. Pain, activities of daily living, health status (SF-36), the strength of the hip abductor muscles and radiological outcome were analysed.

Six weeks after surgery, the patients in the augmented group had significantly lower global and functional pain scores (p < 0.003), less pain after walking 50 feet (p < 0.01), and a better return to the activities of daily living (p < 0.05). At follow-up at six weeks and six months, those in the augmented group showed a significant improvement compared with the control group in the SF-36 score. No other significant differences were found between the groups. We conclude that augmentation with calcium phosphate cement in unstable trochanteric fractures provides a modest reduction in pain and a slight improvement in the quality of life during the course of healing when compared with conventional fixation with a sliding screw device alone.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General