Implants for trochanteric fractures in Norway: the role of the trochanteric stabilizing plate-a study on 20,902 fractures from the Norwegian hip fracture register 2011-2017

Autor: Jan-Erik Gjertsen, Eva Dybvik, Kjell Matre, Carl Erik Alm, Frede Frihagen, Jan Erik Madsen
Rok vydání: 2020
Předmět:
Trochanteric fractures
Male
lcsh:Diseases of the musculoskeletal system
medicine.medical_treatment
Bone Screws
Dentistry
Bone Nails
law.invention
Intramedullary rod
Fracture Fixation
Internal
0302 clinical medicine
lcsh:Orthopedic surgery
law
Orthopedics and Sports Medicine
030212 general & internal medicine
Registries
Aged
80 and over
030222 orthopedics
Hip fracture
Norway
Trochanteric stabilizing plate
language
Female
Sliding hip screw
Bone Plates
Research Article
medicine.medical_specialty
Decision Making
Norwegian
03 medical and health sciences
medicine
Internal fixation
Humans
business.industry
Hip Fractures
Intramedullary nail
Odds ratio
medicine.disease
language.human_language
lcsh:RD701-811
Logistic Models
Orthopedic surgery
Surgery
Implant
Hip Prosthesis
lcsh:RC925-935
business
Decision-making
Zdroj: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
ISSN: 1749-799X
Popis: Background The trochanteric stabilizing plate (TSP) is used as an adjunct to the sliding hip screw (SHS) in unstable trochanteric and subtrochanteric fractures. We wanted to describe the choice of implant for trochanteric fractures with a focus on the TSP in Norway. Methods A total of 20,902 fractures from the Norwegian Hip Fracture Register treated surgically in 43 hospitals from 2011 to 2017 were included. Logistic regression analyses were performed to detect factors potentially influencing implant choice. Results The mean age was 83 years, and 15,137 (72%) were women. An SHS was used in 13,273 (63%) fractures, of them 4407 (33%) with a TSP. Fracture classification was the most important determinant of TSP. In cases where an SHS was used, the odds ratio (OR) for using a TSP was 14 for AO/OTA 31A2 fractures and 71 for AO/OTA 31A3 and subtrochanteric fractures, compared to AO/OTA 31A1 fractures. The probability of receiving a TSP was higher in urban, academic, and high-volume hospitals (OR 1.2 to 1.3) and lower in Central and Northern Norway (OR 0.3 to 0.7). The use of an intramedullary nail (IMN) (n = 7629 (36%)) was also to a degree decided by fracture classification (OR 1.8 to 5.3). However, hospital factors, with OR 0.1 to 0.4 for IMN in academic, urban, and high-volume hospitals and OR 1.5 to 2.6 outside South-Eastern Norway (all p < 0.001), were also important. Conclusions Fracture classification was the main determinant for TSP use. Any additional benefit from a TSP on postoperative fracture stability or clinical outcome needs to be clarified.
Databáze: OpenAIRE
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