RESUMEN
Objetivos. El tratamiento de fracturas pertrocantéreas con clavo DHS (Dynamic Hip Screw) mediante técnica mínimamente invasiva (MIDHS) ha mostrado resultados superiores a la técnica convencional (CDHS) en estudios previos. El presente estudio pretende determinar si existen diferencias en requerimientos transfusionales, morbilidad, estancia hospitalaria y en el coste asociado, a partir de un análisis retrospectivo de 2 cohortes. Material y método. Estudio de cohortes en 80 pacientes con fracturas intertrocantéreas de fémur (31-A1 y 31-A2.1) tratados con implante DHS entre julio de 2005 y septiembre de 2007: 40 de ellos con la técnica convencional y 40 de ellos con técnica MIDHS. Resultados. No se observaron diferencias estadísticamente significativas ni en la pérdida sanguínea, ni en requerimientos transfusionales, ni en morbilidad. La estancia hospitalaria en el grupo MIDHS fue 1,3 días menor, con un coste directo de 306,3 Euros por caso, inferior al grupo CDHS, aunque sin significación estadística (p = 0,3). La duración de la intervención fue menor en el grupo MIDHS: 49,3 versus 78,8 min (p = 0,0001). Discusión. Contrariamente a lo publicado en estudios previos, en el presente estudio la técnica MIDHS no ha mostrado ventajas excepto por requerir un menor tiempo para realizar la técnica. Consideramos que la técnica MIDHS podría ayudar en mejorar la productividad y eficiencia en el uso de quirófanos (AU)
Aim. The treatment of intertrochanteric fractures using a minimally invasive dynamic hip screw (MIDHS) technique has been reported to provide better results than the conventional technique (CDHS). The present study aims to determine whether there are any differences in terms of transfusion needs, morbidity, length of hospital stay, and economical costs, based on a study of two retrospective cohorts. Material and method. Cohorts study of 80 patients with intertrochanteric femoral fractures (31-A1 and 31-A2.1) who underwent DHS procedure from July 2005 to September 2007; 40 of them were treated using the traditional technique (CDHS), and the other 40 using the minimally invasive technique (MIDHS). Results. No differences were found in terms of blood loss, transfusion requirements or morbidity. Mean hospital stay for MIDHS group was 1.3 days lower, reducing the costs regarding the CDHS group by Euros 306.3, but this difference was not statistically significant (P =.3). The time required to perform the surgery was shorter for the MIDHS group: 49.3 versus 78.8 minutes (p = 0.0001). Discussion. Contrary to previous studies published, the present study did not show any advantage for the MIDHS technique, except for a shorter surgical time to perform the procedure. We consider that the MIDHS could help in improving operating room productivity and efficiency (AU)
Asunto(s)
Humanos , Masculino , Femenino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/tendencias , Fracturas de Cadera/cirugía , Estudios Retrospectivos , Estudios de Cohortes , Periodo Posoperatorio , ComorbilidadRESUMEN
AIM: The treatment of intertrochanteric fractures using a minimally invasive dynamic hip screw (MIDHS) technique has been reported to provide better results than the conventional technique (CDHS). The present study aims to determine whether there are any differences in terms of transfusion needs, morbidity, length of hospital stay, and economical costs, based on a study of two retrospective cohorts. MATERIAL AND METHOD: Cohorts study of 80 patients with intertrochanteric femoral fractures (31-A1 and 31-A2.1) who underwent DHS procedure from July 2005 to September 2007; 40 of them were treated using the traditional technique (CDHS), and the other 40 using the minimally invasive technique (MIDHS). RESULTS: No differences were found in terms of blood loss, transfusion requirements or morbidity. Mean hospital stay for MIDHS group was 1.3 days lower, reducing the costs regarding the CDHS group by 306.3, but this difference was not statistically significant (P=.3). The time required to perform the surgery was shorter for the MIDHS group: 49.3 versus 78.8minutes (p=0.0001). DISCUSSION: Contrary to previous studies published, the present study did not show any advantage for the MIDHS technique, except for a shorter surgical time to perform the procedure. We consider that the MIDHS could help in improving operating room productivity and efficiency.