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Extramedullary fixation implants and external fixators for extracapsular hip fractures in adults

  1. Martyn J Parker*,
  2. Avishek Das

Editorial Group: Cochrane Bone, Joint and Muscle Trauma Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 20 SEP 2011

DOI: 10.1002/14651858.CD000339.pub3

How to Cite

Parker MJ, Das A. Extramedullary fixation implants and external fixators for extracapsular hip fractures in adults. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD000339. DOI: 10.1002/14651858.CD000339.pub3.

Author Information

  1. Peterborough and Stamford Hospitals NHS Foundation Trust, Department of Orthopaedics, Peterborough, Cambridgeshire, UK

*Martyn J Parker, Department of Orthopaedics, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, CBU PO Box 211, Bretton Gate, Peterborough, Cambridgeshire, PE3 9GZ, UK. martyn.parker@pbh-tr.nhs.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 28 FEB 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Bannister 1990 {published data only}
  • Bannister GC, Gibson AGF. Jewett nail-plate or AO dynamic hip screw for trochanteric fractures?: a randomised prospective controlled trial [abstract]. Journal of Bone and Joint Surgery - British Volume 1983;65(2):218.
  • Bannister GC, Gibson AGF, Ackroyd CE, Newman JH. The fixation and prognosis of trochanteric fractures: a randomised prospective controlled trial. Clinical Orthopaedics and Related Research 1990;(254):242-6. [MEDLINE: 1990214030]
Buciuto 1998 {published data only}
  • Buciuto R, Hammer R, Herder A. Spontaneous subcapital femoral neck fracture after healed trochanteric fracture. Clinical Orthopaedics and Related Research 1997;(342):156-63. [MEDLINE: 1997453918]
  • Buciuto R, Uhlin B, Hammerby S, Hammer R. RAB-plate vs Richards CHS plate for unstable trochanteric hip fractures: A randomized study of 233 patients with 1-year follow-up. Acta Orthopaedica Scandinavica 1998;69(1):25-8. [MEDLINE: 1998185199]
Esser 1986 {published data only}
  • Esser MP, Kassab JY, Jones DH. Trochanteric fractures of the femur. A randomised prospective trial comparing the Jewett nail-plate with the Dynamic hip screw. Journal of Bone and Joint Surgery - British Volume 1986;68(4):557-60. [MEDLINE: 1986278343]
  • Jones DHA, Kassab J, Esser M. A prospective trial comparing the Jewett nail-plate with the Dynamic Hip Screw [abstract]. Journal of Bone and Joint Surgery - British Volume 1986;68(1):157.
Janzing 2002 {published data only}
  • Brandt SE, Lefever S, Janzing HMJ, Broos PLO, Pilot P, Houben B. Percutaneous compression plating (PCCP) versus dynamic hip screw (DHS) for pertrochanteric hip fractures - preliminary results [abstract]. Journal of Bone and Joint Surgery - British Volume 2001;83 Suppl 2:193-4.
  • Brandt SE, Lefever S, Janzing HMJ, Broos PLO, Pilot P, Houben BJJ. Percutaneous compression plating (PCCP) versus the dynamic hip screw for pertrochanteric hip fractures: preliminary results. Injury 2002;33(5):413-8.
  • Janzing HMJ, Houben B, Broos P. The Gotfried percutaneous compression plate. Surgical technique and prospective randomized comparison with the dynamic screw [abstract]. Hefte zur der Unfallchirurg 2000;282:45.
  • Janzing HMJ, Houben BJJ, Brandt SE, Chhoeurn V, Lefever S, Broos P, et al. The Gotfried percutaneous compression plate versus the dynamic hip screw in the treatment of pertrochanteric hip fractures: minimal invasive treatment reduces operative time and post-operative pain. Journal of Trauma 2002;52(2):293-8.
Karn 2006 {published data only}
  • Karn NK, Singh GK, Kumar P, Shrestha BP, Singh MP, Gowda MJ. Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal. Journal of Bone and Joint Surgery - British Volume 2006;88(10):1347-50.
Kosygan 2002 {published data only}
  • Gotfried Y. The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip [letter]. Journal of Bone and Joint Surgery - British Volume 2003;85:148-9.
  • Kosygan KP, Mohan R, Newman RJ. The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. Journal of Bone and Joint Surgery - British Volume 2002;84(1):19-22.
  • Kosygan KP, Newman RJ. A trial of the percutaneous compression plate and the classic hip screw for the fixation of intertrochanteric fractures of the hip [abstract]. Journal of Bone and Joint Surgery - British Volume 2003;85 Suppl 1:38.
Lizaur Utrilla 1998 {published data only}
  • Lizaur Utrilla A, Cebrian Gomez R, Sebastia Forcada E. Compression screw plate or monoblock nail-plate in trochanteric fractures of the femur in the elderly [Tornillo-placa a compresion o clavo-placa monobloque en las fracturas trocantereas del femur del anciano]. Revista de Ortopedia y Traumatologia 1998;42(5):368-73.
Lunsjo 1999 {published and unpublished data}
  • Lunsjo K. Dynamic fixation of unstable trochanteric hip fractures. A clinical and radiographic evaluation of the Medoff sliding plate [thesis]. Helsingborg: Lund University, 1998.
  • Lunsjo K. Dynamic fixation of unstable trochanteric hip fractures - a clinical and radiographic evaluation of the Medoff sliding plate [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1998;282:68.
  • Lunsjo K, Ceder L, Hamberg P, Tidermark J, Larsson B-E, Allvin I, et al. The Medoff sliding plate versus standard dynamic screw systems in unstable inter-trochanteric and subtrochanteric hip fractures - a preliminary report of a prospective randomised multicenter trial [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1997;274:97.
  • Lunsjo K, Ceder L, Skytting B, Larsson B-E, Allvin B-E. Extramedullary fixation of 107 subtrochanteric fractures. A randomized multicentre trial of the Medoff sliding plate vs three different screw-plate systems [abstract]. Journal of Bone and Joint Surgery - British Volume 1999;81 Suppl 2:164.
  • Lunsjo K, Ceder L, Skytting B, Tidermark J, Larsson B-E, Lindahl L-E, et al. A randomized multicentre trial of the Medoff sliding plate versus standard screw-plate systems in subtrochanteric fractures [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1999;284:70.
  • Lunsjo K, Ceder L, Tidermark J, Hamberg P, Larsson B-E, Ragnarsson B, et al. Extramedullary fixation of 107 subtrochanteric fractures. A randomized multicentre trial of the Medoff sliding plate versus 3 other screw-plate systems. Acta Orthopaedica Scandinavica 1999;70(5):459-66.
Lunsjo 2001 {published data only}
  • Lunsjo K, Ceder L, Hamberg P, Tidermark J, Larsson B-E, Allvin I, et al. The Medoff sliding plate versus standard dynamic screw systems in unstable inter-trochanteric and subtrochanteric hip fractures - a preliminary report of a prospective randomised multicenter trial [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1997;274:97.
  • Lunsjo K, Ceder L, Thorngren KG, Skytting B, Tidermark J, Berntson, et al. Extramedullary fixation of 569 unstable intertrochanteric fractures: a randomized multicenter trial of the Medoff sliding plate versus three other screw-plate systems. Acta Orthopaedica Scandinavica 2001;72(2):133-40.
McCormack 2010 {published data only}
  • McCormack RG, Panagiotopoulos K, Buckley RE, Penner MJ, Perey B, Pate GC, et al. A multicenter PRCT of the DHS vs. Medoff for unstable intertrochanteric hip fractures [abstract]. American Academy of Orthopaedic Surgeons 75th Annual Meeting;2008 Mar 5-9; San Francisco, CA. www3.aaos.org/education/anmeet/anmt2008/podium/podium.cfm?Pevent=387 (accessed 25/02/10). 2008.
  • McCormack RG, Zomar ML, Panagiotopoulos KP, Buckley RE, Penner MJ, Perey BH, et al. A multicentre, prospective randomized comparison of the sliding hip screw versus the Medoff sliding screw and side plate for unstable intertrochanteric hip fractures. Journal of Bone and Joint Surgery - British Volume 2010;92(Supp I):7.
McLaren 1991 {published data only}
Moroni 2005 {published data only}
  • Moroni A, Faldini C, Pegreffi F, Giannini S. Dynamic hip screw vs. external fixation for osteoporotic trochanteric fracture treatment [abstract]. 71st Annual Meeting of the American Academy of Orthopaedic Surgeons; 2004 March 10-14; San Francisco,CA. Paper 167. http://www.aaos.org/wordhtml/anmt2004/sciprog/167.htm (accessed 24 February 2004).
  • Moroni A, Faldini C, Pegreffi F, Giannini S. External fixation for osteoporotic trochanteric fracture patients: a minimally invasive treatment option [abstract]. Journal of Bone and Joint Surgery - British Volume 2004;86 Suppl 3:226.
  • Moroni A, Faldini C, Pegreffi F, Hoang-Kim A, Vannini F, Giannini S. Dynamic hip screw compared with external fixation for treatment of osteoporotic pertrochanteric fractures: A prospective, randomized study. Journal of Bone and Joint Surgery - American Volume 2005;87(4):753-9.
Olsson 2001 {published data only}
  • Olsson O. Alternative techniques in trochanteric hip fracture surgery. Clinical and biomechanical studies on the Medoff sliding plate and the Twin hook. Acta Orthopaedica Scandinavica. Supplementum 2000;295:1-31.
  • Olsson O, Ceder L, Hauggaard A. Femoral shortening in intertrochanteric fractures: a comparison between the Medoff sliding plate and the compression hip screw. Journal of Bone and Joint Surgery - British Volume 2001;83(4):572-8.
  • Olsson O, Ceder L, Hauggaard A, Lunsjo K. Femoral shortening to intertrochanteric fractures - A prospective study of 114 patients randomised to fixation with the Medoff sliding plate or the compression hip screw [abstract]. 68th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2001 Feb 28 - Mar 4: San Francisco (CA). AAOS On-Line Service, 2001:http://www.aaos.org/wordhtml/anmt2001/poster/pe049.htm (accessed 20 June 2001).
Peyser 2007 {published data only}
  • Peyser A, Weil Y, Brocke L, Sela Y, Mosheiff R, Mattan Y, et al. A prospective, randomised study comparing the percutaneous compression pate and the compression hip screw for the treatment of intertrochanteric fractures of the hip. Journal of Bone and Joint Surgery - British Volume 2007;89(9):1210-7.
  • Peyser A, Weil Y, Brocke L, Sela Y, Mosheiff R, Mattan Y, et al. A prospective, randomised study comparing the percutaneous compression pate and the compression hip screw for the treatment of intertrochanteric fractures of the hip. Correction to original article. Journal of Bone and Joint Surgery - British Volume 2008;90(11):1533.
Pitsaer 1993 {published data only}
Vossinakis 2002 {published data only}
  • Vossinakis IC, Badras LS. External fixation for pertrochanteric fractures [letter]. Journal of Bone and Joint Surgery - American Volume 2005;85(11):2252-3.
  • Vossinakis IC, Badras LS. The external fixator compared with the sliding hip screw for pertrochanteric fractures of the femur. Journal of Bone and Joint Surgery - British Volume 2002;84(1):23-9.
  • Vossinakis IC, Skretas E, Bitounis E, Badras LS. Comparison between external fixation and the sliding hip screw in pertrochanteric fractures - a prospective randomised study [abstract]. Journal of Bone and Joint Surgery - British Volume 2001;83 Suppl 2:168.
Watson 1998 {published data only}
  • Watson JT, Moed BR, Cramer KE, Karges DE. Comparison of the compression hip screw with the Medoff sliding plate for intertrochanteric fractures. Clinical Orthopaedics and Related Research 1998;(348):79-86. [MEDLINE: 1998214153]
  • Watson JT, Moed BR, Karges DE, Cramer KE. DHS versus Medoff plate for the treatment of unstable intertrochanteric fractures: a randomized prospective study [abstract]. Annual Meeting of the Orthopaedic Trauma Association; Louisville, Kentucky; Oct 17-19 1997. http://www.hwbf.org/ota/am/ota97/OTA97906.htm (accessed 23 February 2001).
  • Watson JT, Moed BR, Karges DE, Cramer KE. DHS versus Medoff plate for the treatment of unstable intertrochanteric fractures: a randomized prospective study [abstract]. Orthopaedic Transactions 1997;21(4):1355.
Yang 2011 {published data only}
  • Qureshi S, Trokhan S, Yang EC. Prospective randomized study comparing SHS and PCCP for treatment of intertrochanteric hip fractures. 74th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2007 Feb 14-18; San Diego, CA. www3.aaos.org/education/anmeet/anmt2007/education.cfm (accessed 25/09/08). 2007.
  • Yang E, Qureshi S, Trokhan S, Joseph D. Gotfried percutaneous compression plating compared with sliding hip screw fixation of intertrochanteric hip fractures: a prospective randomized study. Journal of Bone & Joint Surgery - American Volume 2011;93(10):942-7.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Enskog 1999 {published data only}
  • Enskog LBD. A new double sliding screw and plate system (LE-plate) versus standard sliding screw and plate system (DHS) in the treatment of trochanteric hip fractures - minimum 12 months follow-up of 31 patients in a randomized prospective study - preliminary report [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1999;287:58.
Heyse-Moore 1983 {published data only (unpublished sought but not used)}
  • Heyse-Moore GH, MacEachern AG, Jameson Evans DC. Treatment of intertrochanteric fractures of the femur: a comparison of the Richards screw-plate with the Jewett nail-plate. Journal of Bone and Joint Surgery - British Volume 1983;65(3):262-7.
Kumar 2006 {published data only}
  • Kumar S, Sen RK, Nagi ON. Hip abductor strength in unstable trochanteric fractures stabilised with DHS-TSP. European Journal of Trauma 2006;32(Supplement 1):24.
Lahav 2007 {published data only}
  • Lahav M, Laufer Y, Gotfried Y. Functional recovery and pain in hip fractures post DHS and PCCP [abstract]. 74th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2007 Feb 14-18;San Diego, CA. 2007.
Laufer 2005 {published data only}
  • Laufer Y, Lahav M, Lenger R, Sprecher E. Functional recovery following pertrochanteric hip fractures fixated with the dynamic hip screw vs. the percutaneous compression plate. Scientific World Journal 2005;5:221-9.
Li 2010 {published data only}
  • Li J, Zhang ZS, Zhao HP, Zhang P, Pan YQ, Wu YF. Anatomical plate versus dynamic hip screw internal fixation for the treatment of femoral intertrochanteric fractures. Journal of Clinical Rehabilitative Tissue Engineering Research 2010;14(35):6627-31.
Moroni 2004 {published data only}
  • Moroni A, Faldini C, Pegreffi F, Giannini S. HA-coated screws decrease the incidence of fixation failure in osteoporotic trochanteric fractures. Clinical Orthopaedics and Related Research 2004;(425):87-92.
Olsson 2000 {published data only}
Ouyang 2010 {published data only}
  • Ouyang ZH, Huang JR, Xiang XJ, Bin H. Effect and complications of metallic implants for internal fixation of upper femoral shaft fracture: Randomized comparison among three groups. Journal of Clinical Rehabilitative Tissue Engineering Research 2010;14(30):5674-7.
Peyser 2005 {published data only}
  • Peyser A, Weil Y, Brocke L, Manor O, Mosheiff R, Liebergall M. Percutaneous compression plating versus compression hip screw fixation for the treatment of intertrochanteric hip fractures. Injury 2005;36(11):1343-49.
Raunest 1995 {published data only}
  • Raunest J, Derra E. Dynamic hip screws in osteosynthesis of petrochanteric femoral fractures - is an extended indication justified in the elderly? [Die dynamische Huftschraube in der osteosynthese pertrochanterer femurfrakturen - Ist eine erweiterte indikation im hohen alter vertrebar?]. Langenbecks Archiv Fur Chirurgie 1995;Suppl II Kongressbericht:1144-7.
Romero 2008 {published data only}
  • Romero JM, Diaz RA, Oropeza YM. Dynamic hip screw vs. percutaneous compression plate for trochanteric fractures [Spanish] [Fracturas pertrocantericas en adultos mayores tratados mediante el tornillo dinamico de cadera vs placa de compresion percutanea]. Acta Ortopedica Mexicana 2008;22(2):115-9.
Weisbrot 2005 {published data only}
  • Weisbrot M, Garti A, Pirotzki A, Yassin M, Hendel D, Robinson D. Percutaneous compression plate vs. DHS in trochanteric fractures. A randomized prospective study [abstract]. Journal of Bone and Joint Surgery - British Volume 2005;87(Suppl 3):379.
Zhen 2010 {published data only}
  • Zhen P, Liu XY, Gao MX, Tian Q. Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture: a controlled clinical trial [Chinese]. China Journal of Orthopaedics and Traumatology 2010;23(5):332-5.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
ChiCTR 2011 {unpublished data only}
  • Hu N, Huang W. Minimally invasive percutaneous compression plating versus dynamic hip screw for intertrochanteric fractures. Chinese Clinical Trial Registry http://www.chictr.org/en/proj/show.aspx?proj=1985 (accessed January 4 2013).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Boutron 2008
  • Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P, CONSORT Group. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 2008;148(4):295-309.
Brandt 2001
  • Brandt SE, Lefever S, Janzing HMJ, Broos PLO, Pilot P, Houben B. Percutaneous compression plating (PCCP) versus dynamic hip screw (DHS) for pertrochanteric hip fractures - preliminary results [abstract]. Journal of Bone and Joint Surgery - British Volume 2001;83 Suppl 2:193-4.
Buciuto 1997
  • Buciuto R, Hammer R, Herder A. Spontaneous subcapital femoral neck fracture after healed trochanteric fracture. Clinical Orthopaedics and Related Research 1997;(342):156-63. [MEDLINE: 1997453918]
Chinoy 1999
Gotfried 2000
Gotfried 2003
  • Gotfried Y. The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip [letter]. Journal of Bone and Joint Surgery - British Volume 2003;85:148-9.
Gulberg 1997
Higgins 2003
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Lefebvre 2011
  • Lefebvre C, Manheimer E, Glanville J. Chapter 6.4.11: Search filters. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Lunsjo 1996
  • Lunsjo K, Ceder L, Stigsson L, Hauggaard A. Two-way compression along the shaft and the neck of the femur with the Medoff sliding plate: one-year follow-up of 108 intertrochanteric fractures. Journal of Bone and Joint Surgery - British Volume 1996;78(3):387-409.
Lunsjo 1997
  • Lunsjo K, Ceder L, Hamberg P, Tidermark J, Larsson B-E, Allvin I, et al. The Medoff sliding plate versus standard dynamic screw systems in unstable inter-trochanteric and subtrochanteric hip fractures - a preliminary report of a prospective randomised multicenter trial [abstract]. Acta Orthopaedica Scandinavica. Supplementum 1997;274:97.
Medoff 1991
  • Medoff RJ, Maes K. A new device for the fixation of unstable pertrochanteric fractures of the hip. Journal of Bone and Joint Surgery - American Volume 1991;73(8):1192-9.
Olsson 1997
  • Olsson O, Ceder L, Lunsjo K, Hauggaard A. Biaxial dynamization in unstable intertrochanteric fractures: good experience with a simplified Medoff sliding plate in 94 patients. Acta Orthopaedica Scandinavica 1997;68(4):327-31.
Parker 2002
  • Parker MJ. Trochanteric and subtrochanteric fractures. In: Bulstrode C, Buckwalter J, Carr A, Marsh L, Fairbank J, Wilson-MacDonald J, et al. editor(s). Oxford textbook of orthopaedics and trauma. 1st Edition. Oxford: Oxford University Press, 2002:2228-39.
Parker 2010
  • Parker MJ, Handoll HHG. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database of Systematic Reviews 2010, Issue 9. [DOI: 10.1002/14651858.CD000093.pub5]
Pugh 1955
  • Pugh WL. A self-adjusting nail-plate for fractures about the hip joint. Journal of Bone and Joint Surgery - American Volume 1955;37(5):1085-93.
Zuckerman 2000

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Parker 2006
  • Parker MJ, Handoll HHG. Extramedullary fixation implants and external fixators for extracapsular hip fractures in adults. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD000339.pub2]