Fracturas inestables de cadera tratadas mediante osteosíntesis con placa de compresión percutánea (Placa Gotfried)

Abstract

From DHS, in 1998, Gotfried developed an implant, the percutaneous compression plate (PCCP), as a system for the treatment of stable pertrochanteric fractures applied as a minimally invasive procedure. It allows controlled impaction and prevents rotation of the femoral head. It preserves the lateral wall of the greater trochanter. Based on the properties and biomechanical advantages of the PCCP, supported by the experimental study carried by Brandt in 2016, the PCCP showed greater axial load resistance and torque in stable and unstable intracapsular fractures. Those results were reproduced in cadaveric examples. We undertook the challenge of using PCCP in unstable hip fractures where it is not the conventional indication.

Objectives: To standardize the use of this system in hip fractures where indications have not been fully reported or supported in clinical trials.
Materials and Methods: this study is a control trial made in the period of January 2016 to November 2018. Patients had unstable hip fractures. They were resolved by closed reduction and osteosynthesis with Gotfried plate.

Results: based on Harris functional hip scale we obtained excellent and good results in 88% of the cases, 10% regular and 2% bad. Radiologically, a delay in consolidation, no vicious consolidations nor fractures of the lateral wall of the greater trochanter were present. Conclusions: PCCP can be used in unstable hip fractures. The discharge of the affected member for a period of 6 weeks is necessary as a contribution for bone graft.

The conversion of the lateral wall of the trochanter is a preponderant factor for dismiss a reintervention and have a good recovery.