[Proximal cut-out of the hip screw: cement augmentation as a minimally invasive rescue procedure].

BACKGROUND

Cemented augmentation of osteosynthesis for the treatment of peritrochanteric fractures in elderly patients has been under discussion for years. We propose this option as a salvage procedure in cases of instability after standard osteosynthesis.

MATERIAL AND

METHODS

After reduction and optional re-osteosynthesis a Jamshidi needle is placed transcutanously or through the open wound cranio-lateral of the tip of the hip screw. Cement augmentation can be performed under fluoroscopic control. The patients were monitored for at least 7 months postoperatively to rule out a redislocation.

RESULTS

From 1/2009 to 1/2011 we treated 6 patients (5 female, 1 male, age 83.8 [79-94] years). We performed 4 augmentations and 2 augmentations with additional re-osteosynthesis. OP time was 26.8 (13-45) minutes. The revision was performed 9.7 (4-14) days after the osteosynthesis. Within 14.7 (7-28) months no redislocation and no surgical complication occurred.

CONCLUSION

Even with a small patient number the good results show the potential of this minimally invasive technique. In our opinion this option allows a fast and technically easy salvage procedure without blocking of further treatment options like a prosthesis.