Anterior approach without traction table: A means of saving time and money in hemiarthroplasty for femoral neck fracture? A case-matched study with and without traction table - 25/04/20
, David Biau, Aymane Moslemi, Jules Descamps, Philippe Anract, Alexandre Hardy
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
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Abstract |
Background |
The costs incurred by management of displaced femoral neck fracture are a public health issue. The anterior approach can be used for partial hip replacement, but costs in terms of equipment and time incurred by using a traction table have not to our knowledge been estimated in this indication. We therefore performed a case-control study, comparing (1) installation and deinstallation times (IT, DT) in partial hip replacement using a standard versus a traction table (ST, TT), and (2) operating times, limb-length radiography and intraoperative complications.
Hypothesis |
Performing the anterior approach on a standard table saves installation and deinstallation time and operating time, without leading to more intraoperative complications.
Materials and methods |
A comparative retrospective study included 102 patients (mean age, 84.8±8 years; 46 ST, 56 TT). Installation time (IT) was calculated between entry in the operating room and performance of the incision; operating time (OT) between incision and closure; and deinstallation time (DT) between closure and leaving the operating room.
Results |
Mean IT in ST (25.5±6.2min) was significantly shorter than in TT (33.9±6.2min) (p=1.1*10−9), as were DT (13±4.7 versus 17±3.4min) (p=4.1*10−6) and OT (73.5±15.9 versus 82.6±21.3minutes) (p=0.01). There were 4 intraoperative complications: 1 greater trochanter fracture in ST and 2 greater trochanter fractures and 1 proximal femoral fracture in TT. Limb-length discrepancy was comparable between ST (3.7±3.2mm (range, 0-15mm)) and TT (5.3±4.6mm (range, 0-20mm)) (p=0.06).
Discussion |
Patient installation on a standard table reduced installation, deinstallation and operating time compared to use of a traction table, without increasing the complications rate.
Level of evidence |
III, case-control study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Hip replacement, Femoral neck fracture, Anterior approach, Time, Installation, Standard table
Abbreviations : IT, DT, OT, ST, TT
Mappa
Vol 106 - N° 3
P. 583-588 - maggio 2020 Ritorno al numero
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Benvenuto su EM|consulte, il riferimento dei professionisti della salute.