Abstract
A randomised, prospective trial comparing the percutaneous compression plate (PCCP) and the classic hip screw was performed for intertrochanteric fractures of the femur in 108 patients. The PCCP offers the ability to stabilise fractures with a minimal exposure and periosteal stripping thus preserving soft tissue cover.
Over a 19-month period all patients with extra-capsular fractures apart from subtrochanteric and pathologic fractures were included. They were classified as per Evans classification.
The patient’s pre-operative haemoglobin, premorbid mobility, medical and mental status were noted. The duration of the procedure, screening time, blood loss and any technical difficulty encountered along with the post-operative haemoglobin, drainage and transfusion requirements, as well as the length of stay in the orthopaedic unit and total length of stay in the hospital were recorded. Results were analysed using the Chi-square test and Student’s test.
The operating time was significantly longer in the PCCP group (mean 59vs49mins,P< 0.05). There was no significant difference between the two groups with regard to the other parameters measured.
There was no difference in the failure rate (2 cut-outs in the CHS group and one screw back-out in the PCCP.) With the device being of fixed single angled design it proved to be unsuitable for 3 patients.
The PCCP would appear to be as good as the more conventional device though it does not confer the perceived advantages of decreased duration of stay or significant reduction in transfusion requirement which are associated with other percutaneous procedures. The device is a single fixed angle one and is therefore not universally applicable to all patients.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
