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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1210-1217.
doi: 10.1302/0301-620X.89B9.18824  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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A prospective, randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip

A. Peyser, MD, Senior Orthopaedic Surgeon1; Y. A. Weil, MD, Senior Orthopaedic Surgeon1; L. Brocke, PhD, Research Coordinator1; Y. Sela, MD, Medical Student (MD thesis)1; R. Mosheiff, MD, Professor of Orthopaedic Surgery1; Y. Mattan, MD, Senior Orthopaedic Surgeon1; O. Manor, PhD, Statistician2; and M. Liebergall, MD, Professorof Orthopaedic Surgery and Chairman1

1 Department of Orthopaedic Surgery
2 Braun School of Public Health and Community Medicine, Hadassah-Hebrew University Medical Centre, P. O. Box 12000, Jerusalem 92110, Israel.

Correspondence should be sent to Dr A. Peyser; e-mail: peysera{at}hadassah.org.il

Limited access surgery is thought to reduce post-operative morbidity and provide faster recovery of function. The percutaneous compression plate (PCCP) is a recently introduced device for the fixation of intertrochanteric fractures with minimal exposure. It has several potential mechanical advantages over the conventional compression hip screw (CHS). Our aim in this prospective, randomised, controlled study was to compare the outcome of patients operated on using these two devices.

We randomised 104 patients with intertrochanteric fractures (AO/OTA 31.A1–A2) to surgical treatment with either the PCCP or CHS and followed them for one year postoperatively.

The mean operating blood loss was 161.0 ml (8 to 450) in the PCCP group and 374.0 ml (11 to 980) in the CHS group (Student’s t-test, p < 0.0001). The pain score and ability to bear weight were significantly better in the PCCP group at six weeks post-operatively. Analysis of the radiographs in a proportion of the patients revealed a reduced amount of medial displacement in the PCCP group (two patients, 4%) compared with the CHS group (10 patients, 18.9%); Fisher’s exact test, p < 0.02.

The PCCP device was associated with reduced intra-operative blood loss, less postoperative pain and a reduced incidence of collapse of the fracture.






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