Fixation of Intertrochanteric Fractures with Dynamic Hip Screws: Randomized Controlled Trial Comparing Hardinge and Minimally Invasive Approaches^[*]

Abstract

Objective To compare the techniques for the osteosynthesis of intertrochanteric fractures with dynamic hip screws (DHSs) through the Hardinge and minimally-invasive access routes of the hip, evaluating the operative time, the degree of pain in the immediate postoperative period, the hematimetric loss, and the functional aspects of active mobility.

Methods A randomized, double-blinded clinical trial in which 66 patients with intertrochanteric fractures were submitted to osteosynthesis by DHS. The patients were divided into a test group, submitted to the minimally-invasive access, and a control group, in whom the surgery was performed through the Hardinge route.

Results Patients submitted to the minimally-invasive treatment presented a lower degree of postoperative pain compared to the group treated by the Hardinge lateral route (p < 0.001), as well as lower hematimetric loss (p < 0.001), shorter operative time (p < 0.001), and improvement in immediate postoperative active mobility tests (p <0.05).

Conclusion The study demonstrated the clinical superiority of the minimally-invasive access route parameters analyzed in relation to the Hardinge access for the fixation of intertrochanteric fractures when DHS is the choice osteosynthesis method.

Level of evidence I.

Keywords

intertrochanteric fracture - minimally-invasive surgical procedures - osteosynthesis - pain, postoperative - clinical trial

Sources of Funding

The present research did not receive any specific grants from funding agencies in the public, commercial or non-profit sectors.

^* Work developed at Universidade do Estado do Amazonas (UEA), Boca do Acre, AM, Brazil.

Publication History

Received: 07 May 2020

Accepted: 14 October 2021

Article published online:
18 February 2022

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