Abstract
Design
Prospective randomised comparative study.
Objectives
To analyse and compare serum soft-tissue marker differences after dynamic hip screw
(DHS) and proximal femoral nail (PFN) fixation of stable intertrochanteric fractures
in the elderly.
Materials and methods
Twenty elderly patients (>60 years old) with a stable intertrochanteric fracture were
enrolled in this study. Patients were divided into two groups of 10 each according
to the device used (DHS or PFN). All 20 patients had a stable intertrochanteric fracture,
and all were operated on by the same surgeon using minimal invasive approach. A biochemical
comparison of soft-tissue serum markers was performed. The serum markers examined
were haemoglobin (Hb), haematocrit (Hct), creatine kinase (CK), myoglobin (MYO), troponin
I and C-reactive protein (CRP), and their levels were determined before surgery, and
1, 8, 16, 24, 36, 48 and 72 h after surgery. Differences between the DHS and PFN groups were compared.
Results
No inter-group differences were observed with respect to preoperative demographics,
operation time, incision length or blood loss. In terms of serum markers, both methods
showed similar patterns of change for CK, MYO and CRP pre- to post-operatively. In
addition, pre- and post-operative Hb and Hct levels were similar. Furthermore, no
inter-group differences were observed between the absolute values of serum markers
at any point.
Conclusion
The absolute values and temporal changes of serum markers were similar in the two
study groups. These findings suggest that DHS and PFN fixation of stable intertrochanteric
fractures produce similar levels of soft-tissue damage.
Keywords
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Article info
Publication history
Accepted:
September 6,
2010
Received in revised form:
August 27,
2010
Received:
April 26,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
