gms | German Medical Science

4. Alterstraumatologie Kongress 2018

22.03. - 23.03.2018, Zürich Regensdorf, Schweiz

Cement-Augmentation of the proximal femur nail antirotation – is it really safe?

Meeting Abstract

  • presenting/speaker Konrad Schütze - Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Deutschland
  • Bertram Hummel - Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Deutschland
  • Alexander Eickhoff - Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Deutschland
  • Florian Gebhard - Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Deutschland
  • Peter Richter - Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm, Deutschland

Deutsche Gesellschaft für Geriatrie e.V. (DGG). Deutsche Gesellschaft für Unfallchirurgie e.V. (DGU). 4. Alterstraumatologie Kongress 2018. Zürich Regensdorf, Schweiz, 22.-23.03.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18

doi: 10.3205/18altra18, urn:nbn:de:0183-18altra186

Veröffentlicht: 13. März 2018

© 2018 Schütze et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Management of unstable proximal femur fractures in osteoporotic patients is a rising challenge in orthopedic trauma. Cement augmentation of the proximal femur nail showed promising biomechanical und clinical results. The goal of this study is to investigate cement related complication intra- and postoperative.

Methods: A retrospective chart review of 299 patients (mean age 80 +/- 13 years; 205 women and 94 men) with inter- or subtrochanteric fractures between January 2015 and December 2016 was performed. In all cases the proximal femur nail antirotation (Fa. DePuy Synthes) was implanted. Augmentation was performed with Traumacem V+ Cement (Fa. DePuy Synthes) in 152 cases. Before augmentation a radiological contrast agent is applied to ensure there is no leakage into the joint. Statistical analysis was done using the chi-square-test to test between the groups. Afterwards logistic regression was used to eliminate confounding effects.

Result: Intraoperatively a total of 57 out of 152 augmented cases needed an intervention with vasoactive medication directly after augmentation. The risk for an intervention was 3.6-fold higher compared to the non-augmentation group. Mean blood pressure change after augmentation was 8 +/- 7,4 mmHg. There was no significant difference in the hospital or 1-year mortality between augmented and non-augmented cases. Also, augmentation showed no higher rate of postoperative complications like stroke, heart attack or infection. In 152 augmented cases, there was no leakage of cement into the joint. No signs of mechanical failure were seen in the 299 cases.

The retrospective review showed no major complications associated with cement augmentation of the proximal femur nail. There is a significant augmentation-related blood pressure drop shortly after inserting the cement with a 3.6-fold higher risk for the need of an intervention with a vasoactive medication. In the 299 reviewed cases the augmentation rate was about 50% without any leakage of cement into the joint. Furthermore, no mechanical failure in all the cases after 6 weeks was reported.