Greater trochanter fractures in the direct anterior approach: evolution during learning curve, risk factors and consequences.
Arch Orthop Trauma Surg
; 141(4): 675-681, 2021 Apr.
Article
em En
| MEDLINE
| ID: mdl-33417023
ABSTRACT
INTRODUCTION:
Greater trochanter (GT) fractures affect 0.6-29% of patients after direct anterior approach (DAA) total hip arthroplasty (THA). Given the growing popularity of this approach, this study aimed to assess the evolution of the GT fractures during the learning curve, their risk factors and their consequences. MATERIALS ANDMETHODS:
537 total hip arthroplasties were retrospectively included from May 2013 to December 2017 in a single academic centre. Patient characteristics, perioperative management, clinical consequences and postoperative radiographs were analysed.RESULTS:
GT fractures represented 2.4% (n = 13) of the THA, and there was not a decrease with experience. The GT fracture patients did not require any additional support during the surgery, and full weight bearing was always allowed without any restriction. This complication only happened in females, with the risk significantly increased in those > 70 years old (OR = 4.9). There was no specific consequence during the follow-up, mean HHS score was 98.5 and all of the patients were satisfied or very satisfied postoperatively.CONCLUSION:
Older osteoporotic women are known to be at risk for GT fracture during DAA THA. Those results reinforce the argument in favour of proper patient selection in DAA to lower the complications since it does not improve with surgeon's experience. LEVEL OF EVIDENCE Retrospective, consecutive case series; Level IV.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artroplastia de Quadril
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Fraturas do Fêmur
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Fêmur
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França