Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(01): 109-113
DOI: 10.1055/s-0040-1716758
Nota Técnica
Trauma

Minimally Invasive Osteosynthesis of Transtrochanteric Fractures with Dynamic Hip Screw (DHS)[*]

Article in several languages: português | English
José André Melo Barreto Guimarães 
1   Hospital São Vicente, Serra Talhada, PE, Brasil
,
Marcos Cezar Feitosa de Paula Machado 
2   Faculdade de Medicina (Campus Serra Talhada), Universidade de Pernambuco, Serra Talhada, PE, Brasil
,
Pauliana Valéria Machado Galvão 
2   Faculdade de Medicina (Campus Serra Talhada), Universidade de Pernambuco, Serra Talhada, PE, Brasil
,
Jéssika Cristina de Lima 
2   Faculdade de Medicina (Campus Serra Talhada), Universidade de Pernambuco, Serra Talhada, PE, Brasil
,
Lucas dos Santos Gomes 
2   Faculdade de Medicina (Campus Serra Talhada), Universidade de Pernambuco, Serra Talhada, PE, Brasil
,
Pedro Ferreira Barreto Guimarães 
3   Faculdade de Medicina de Olinda (FMO), Olinda, PE, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

The method presented here consists of a minimally invasive surgical technique for osteosynthesis of transtrochanteric fractures with Dynamic Hip Screw (DHS) 135°. It is indicated in the treatment of 31-A1 and 31-A2 fractures (Arbeitsgemeinschaft für Osteosynthesefragen Classification - AO) that meet the prerequisites required for using DHS. The surgery is performed, preferably, before 48 hours after the fracture. With the use of the same instruments as the traditional surgical technique and the aid of the C-arm, a closed reduction of the fracture and implantation of the DHS is performed by a 2-cm surgical incision, through dissection of the underlying tissues, with minimal bleeding and damage to the soft parts. In the immediate postoperative period, the patient is encouraged to orthostatism and walk with full load, which anticipates hospital discharge and favors early functional rehabilitation. Outpatient return is scheduled at 2, 6, 12 and 24 weeks postoperatively, with radiographic evaluation to assess fracture healing.

Keywords

femoral fractures - hip fractures - minimally invasive surgical procedures

* Work developed at the Hospital São Vicente, Serra Talhada, PE, Brazil.




Publication History

Received: 14 May 2020

Accepted: 06 July 2020

Article published online:
25 September 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Bottle A, Aylin P. Mortality associated with delay in operation after hip fracture: observational study. BMJ 2006; 332 (7547): 947-951
    CrossrefPubMedGoogle Scholar
  • 2 Matre K, Havelin LI, Gjertsen JE, Vinje T, Espehaug B, Fevang JM. Sliding hip screw versus IM nail in reverse oblique trochanteric and subtrochanteric fractures. A study of 2716 patients in the Norwegian Hip Fracture Register. Injury 2013; 44 (06) 735-742
    CrossrefPubMedGoogle Scholar
  • 3 Kellam JF. Tratamento cirúrgico de fraturas intertrocantéricas. In: Sledge CB. Quadril. Rio de Janeiro: Revinter; 2005: 109-128
    Google Scholar
  • 4 Shen J, Hu C, Yu S, Huang K, Xie Z. A meta-analysis of percutenous compression plate versus intramedullary nail for treatment of intertrochanteric HIP fractures. Int J Surg 2016; 29: 151-158
    CrossrefPubMedGoogle Scholar
  • 5 Thaeter M, Kobbe P, Verhaven E, Pape HC. Minimally Invasive Techniques in Orthopedic Trauma. Curr Trauma Rep 2016; 2 (04) 232-237
    CrossrefGoogle Scholar
  • 6 Hsu CE, Shih CM, Wang CC, Huang KC. Lateral femoral wall thickness. A reliable predictor of post-operative lateral wall fracture in intertrochanteric fractures. Bone Joint J 2013; 95-B (08) 1134-1138
    CrossrefPubMedGoogle Scholar
  • 7 Sledge CB. Quadril – Master Techniques in Orthopaedic Surgery. Rio de Janeiro: Revinter; 2005
    Google Scholar
  • 8 Sawaia RN, Belangero WD. Sistema MINUS® - Técnica Minimamente Invasiva para o tratamento das FraturasTranstrocanterianas do Fêmur. Rev Bras Ortop 2012; 47 (01) 113-117
    CrossrefPubMedGoogle Scholar