Comparative study between biologic plating and intramedullary nailing for the treatment of subtrochanteric fractures: Is biologic plating using LCP-DF superior to intramedullary nailing?

Abstract

BACKGROUND:

The objective of this study is to evaluate the outcome measures of subtrochanteric fractures between biologic plating and intramedullary nailing and determine if biologic plating is superior to intramedullary nailing.

METHODS:

Between March 2009 and December 2015, 81 patients with subtrochanteric fractures were enrolled (52 males and 29 females; 31 treated with biologic plating and 50 with intramedullary nailing). Biologic plating was conducted consecutively between May 2011 and March 2013 and intramedullary nailing was performed for the rest of period. Perioperative outcomes including operation time and blood loss during the operation; postoperative radiologic outcomes including union, time to union, coronal alignment, and shortening of the femur; and clinical outcomes including walking ability and pain were evaluated. The biologic plating group was compared with the intramedullary nailing group as a historical control.

RESULTS:

No significant differences were identified for bony union and time to union between the two different fixation methods Coronal alignment was significantly better in the biologic plating group than in the intramedullary nailing group (p<0.016). Postoperative coronal alignment was the only risk factor associated with the nonunion of subtrochanteric fractures (unadjusted OR: 1.915, 95% CI: 0.190 - 19.273; adjusted OR: 0.042, 95% CI: 0.000 - 21.517; p=0.320).

CONCLUSION:

Surgical outcomes using LCP-DF are comparable to those using intramedullary nailing. Further clinical studies with a larger sample size are required to show the advantage of biologic plating for the treatment of subtrochanteric fractures.

• Authors: Won Chul Shin, Nam Hoon Moon, Jae Hoon Jang, Hee Jin Lee, Kuen Tak Suh
• Journal: Injury (Injury) Vol. 48 Issue 10 Pg. 2207-2213 (Oct 2017) ISSN: 1879-0267 [Electronic] Netherlands
• PMID: 28847590 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemical References

• Biological Products

Topics

• Adult
• Aged
• Biological Products (pharmacology)
• Biomechanical Phenomena
• Bone Nails
• Bone Plates
• Female
• Fracture Fixation, Intramedullary (instrumentation, methods)
• Fracture Healing
• Hip Fractures (diagnostic imaging, physiopathology, surgery)
• Humans
• Male
• Middle Aged
• Radiography
• Retrospective Studies
• Treatment Outcome
• Young Adult