Background

Recent literature points out the potential interest of standing and sitting X-rays for the evaluation of THA patients. The accuracy of the anterior pelvic plane measures is questionable due to the variations in the quality of lateral standing and sitting X-rays. The EOS® (EOS imaging, Paris, France) is an innovative slot-scanning radiograph system allowing the acquisition of radiograph images while the patient is in weightbearing position with less irradiation than standard imagers. This study reports the “functionnal” positions of a 150 THA cohort, including the lateral orientation of the cups.

Purpose: 151 patients with intertrochanteric (IT) fracture of femur were treated in our department, between July 2002 and December 2003. We used this system as the only system of fixation for intertrochanteric fractures, no other system of fixation was even considered. We wish to evaluate our results and report the findings.

Materials and Methods: A total of 151 patients with an IT fracture were treated, all of them underwent surgery. 152 surgeries were performed in the 151 patients, one of the patients underwent a bilateral surgery. The follow up period was 9 months to a maximum of 12 months. 34 male and 117 female patients were operated. 75 of the fractures were right and 77 left sided. One of four surgeons was involved in all the surgeries.

Results: Time of surgery varied between 25 min to 1 hrs and 15 min, the vast majority of the surgeries took around 30 min. The time of surgery depended on the experience of the surgical team i.e. surgeon, nursing staff and fluoroscopic technician, ease and quality of reduction and its stability. All surgical wounds healed well. No wound infection was encountered, there was no immediate post operative mortality,. 151 out of 152 fractures had no significant loss of fixation and one patient broke all the 3 shaft screws with loss of fixation but the screws in the head continued to hold and had to be revised to a nailing. Almost every patient received a unit of blood to maintain a minimum of 9.0gm % of Hemoglobin level. Blood loss during surgery was estimated to be between 50 –150 ml as per surgical team estimates. Post surgical wound drainage varied between 25 ml to 75 ml.

Conclusions: The PCCP is a reliable and quick system of internal fixation for IT fractures, gives excellent results by all standards, with early and successful return to function.