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Non-operative management of intracapsular femoral neck fractures
202 to the pre-operative level in half of the patients. Almost all patients were mobilized with full weight bearing. In contrast to the literature about pertrochanteric fracture treatment only very few implant failures occurred and the clinical and social outcome were improved. Conclusion: The PCCP is a reliable minimal invasive device. The patients mainly benefit from the smaller incision, less need for blood transfusion, early mobilisation and a reduced rate of complications. Keywords: Pertrochanteric fracture; Minimal invasive surgery; PCCP doi:10.1016/j.injury.2007.11.404 [O115] Short- versus long-thread cannulated screws for intracapsular hip fractures: A randomised trial of 432 patients S.M. Ali ∗ , S. Haleem, M.J. Parker Peterborough District Hospital, UK It is unclear which length of thread may be most advantageous for the internal fixation of an intracapsular fracture with cancellous screws. We have compared the 16 mm versus the 32 mm threads on cancellous screws within a randomised trial for 432 patients. All fractures were fixed with three screws and patients followed-up for a minimum of 1 year from injury. The characteristics of the patients in the two groups was similar with a mean age of 76 years. Twenty-three per cent were male. The most common complication encountered was non-union of the fracture which for undisplaced fractures occurred in 7/107 (6.5%) of short-threaded screws versus 11/133 (8.3%) of long-threaded screws. For displaced fractures the figures were 29/104 (27.9%) versus 24/89 (27.0%). Other complications for the short- versus longthreaded group were avascular necrosis (two cases versus five cases) and fracture below the implant (two cases in each group). Elective removal of the screws for discomfort was undertaken in five and three cases, respectively. None of these differences between groups was statistically significant. In summary there is no difference in fracture healing complications related to the length of the screw threads. Keywords: Hip fracture; Intracapsular; Cannulated screws
Abstract [O117] Distal tibial fracture fixation with locking compression plate (LCP) through minimally invasive percutaneous osteosynthesis (MIPO) technique R. Shahid ∗ , A. Mushtaq, V. Sharma, M. Maqsood Lincoln County Hospital, United Kingdom Treatment of distal tibial fractures has always been a challenge. Common complications include soft tissue necrosis, infection, non-union and malunion. Distal tibia being more superficial, comparatively less soft tissue coverage, less blood supply makes it more prone for the above complications. We aim to see the results of the distal tibial fracture fixation with LCP using MIPO. Twenty-two consecutive patients were treated with LCP for the complex distal tibial fractures using MIPO. Distal tibial fractures of AO type 43a 43b 43c were included. Patients’ age ranged 18—91 years, 63% male and 37% female, 70% were involved in RTA and 30% were fall from height, all patients had associated fibular fracture. One surgeon who has special interest and expertise for locking compression plate operated all patients. Post-fixation patients were allowed to start early active and passive exercise at ankle and knee joints but stayed non-weight bearing for 8—12 weeks depending on the radiological appearance. The patients were regularly assessed clinically and plain radiographic evaluation was performed to assess fracture healing and complications. Twenty-two fractures were fixed with LCP through MIPO technique. Mean time to union was 12 weeks. Nineteen fracture healed with good functional out-come. Two patients had delayed union treated conservatively. One patient had implant failure, which was revised and ultimately healed with good functional outcome. Different methods have been in practice. Many of them have presented with difficulty in managing this complex fracture. LCP for distal tibia has shown excellent results with many additional advantages over the conventional techniques. LCP distal tibia is used with MIPO technique, with minimal damage to soft tissue and blood supply as well as with axially and rotationally stable construct. Rehabilitation is easy with no need of any plaster support. Keywords: Locking compression plate (LCP); Minimally invasive percutaneous plate osteosynthesis (MIPO)
doi:10.1016/j.injury.2007.11.405 [O116] Non-operative management of intracapsular femoral neck fractures J.J. Gregory ∗ , K. Kostakopoulou, A. Kotecha, D.J. Ford, W.P. Cool Royal Shrewsbury Hospital, UK This abstract can be found at the beginning as it is one of the winning abstracts of the Injury Journal Award. doi:10.1016/j.injury.2007.11.406
doi:10.1016/j.injury.2007.11.407 [O118] Anterior knee pain after T2 intramedullary nailing of tibial fracture: A multicentre prospective clinical study R. Jairam 1,∗ , E. Tsiridis 2 , S. Rhemrev 3 , P. de Lucas 4 , K. Westermann 5 1
Private Clinic de Blaak, The Netherlands St. James’s Hospital Leeds, United Kingdom 3 Medisch Centrum Hagglanden, The Netherlands 4 Hospital Universitario Ramon y Cajal, Spain 5 Klinikum Hannover, Germany 2
Anterior knee pain is one of the most frequent complication of tibial nailing. Its aetiology remains unclear potentially
Abstract [O117] Distal tibial fracture fixation with locking compression plate (LCP) through minimally invasive percutaneous osteosynthesis (MIPO) technique R. Shahid ∗ , A. Mushtaq, V. Sharma, M. Maqsood Lincoln County Hospital, United Kingdom Treatment of distal tibial fractures has always been a challenge. Common complications include soft tissue necrosis, infection, non-union and malunion. Distal tibia being more superficial, comparatively less soft tissue coverage, less blood supply makes it more prone for the above complications. We aim to see the results of the distal tibial fracture fixation with LCP using MIPO. Twenty-two consecutive patients were treated with LCP for the complex distal tibial fractures using MIPO. Distal tibial fractures of AO type 43a 43b 43c were included. Patients’ age ranged 18—91 years, 63% male and 37% female, 70% were involved in RTA and 30% were fall from height, all patients had associated fibular fracture. One surgeon who has special interest and expertise for locking compression plate operated all patients. Post-fixation patients were allowed to start early active and passive exercise at ankle and knee joints but stayed non-weight bearing for 8—12 weeks depending on the radiological appearance. The patients were regularly assessed clinically and plain radiographic evaluation was performed to assess fracture healing and complications. Twenty-two fractures were fixed with LCP through MIPO technique. Mean time to union was 12 weeks. Nineteen fracture healed with good functional out-come. Two patients had delayed union treated conservatively. One patient had implant failure, which was revised and ultimately healed with good functional outcome. Different methods have been in practice. Many of them have presented with difficulty in managing this complex fracture. LCP for distal tibia has shown excellent results with many additional advantages over the conventional techniques. LCP distal tibia is used with MIPO technique, with minimal damage to soft tissue and blood supply as well as with axially and rotationally stable construct. Rehabilitation is easy with no need of any plaster support. Keywords: Locking compression plate (LCP); Minimally invasive percutaneous plate osteosynthesis (MIPO)
doi:10.1016/j.injury.2007.11.405 [O116] Non-operative management of intracapsular femoral neck fractures J.J. Gregory ∗ , K. Kostakopoulou, A. Kotecha, D.J. Ford, W.P. Cool Royal Shrewsbury Hospital, UK This abstract can be found at the beginning as it is one of the winning abstracts of the Injury Journal Award. doi:10.1016/j.injury.2007.11.406
doi:10.1016/j.injury.2007.11.407 [O118] Anterior knee pain after T2 intramedullary nailing of tibial fracture: A multicentre prospective clinical study R. Jairam 1,∗ , E. Tsiridis 2 , S. Rhemrev 3 , P. de Lucas 4 , K. Westermann 5 1
Private Clinic de Blaak, The Netherlands St. James’s Hospital Leeds, United Kingdom 3 Medisch Centrum Hagglanden, The Netherlands 4 Hospital Universitario Ramon y Cajal, Spain 5 Klinikum Hannover, Germany 2
Anterior knee pain is one of the most frequent complication of tibial nailing. Its aetiology remains unclear potentially