Percutaneous compression plating may offer benefits in operating times, blood loss

Yang E. J Bone Joint Surg (Am). 2011. doi:10.2106/JBJS.I.00849.

Gotfried percutaneous compression plating yielded reduced operating times, shorter incision length and less blood loss compared with a sliding hip screw, according to these prospective, randomized trial results.

Between July 2004 and September 2007, Edward Yang, MD, of Elmhurst, NY, and colleagues conducted a single-blinded study that included 66 patients with a mean age of 77 years. The researchers randomized 33 patients to treatment with a sliding hip screw and 33 patients to receive a percutaneous compression plate.

The researchers assessed surgical time, incision length, blood loss, the need for blood transfusion and postoperative functional status. Follow-up focused on clinical findings, radiographs until confirmed healing, functional and pain assessment scores, and the SF-36. Median follow-up for surviving patients was 36 months.

The percutaneous compression plating group had shorter operative times (48 minutes vs. 78 minutes), smaller incisions (56 mm vs. 82 mm) and less blood loss (41 mL vs. 101 mL). At discharge, fewer patients with percutaneous compression plates needed walking aids (40% vs. 59%). While this trend was consistent throughout the trial, it never reached significance. Pain with activity was less in the percutaneous compression plate group; however, the difference only reached significance at the 3-month interval.

“This study supported previous research which suggested that percutaneous compression plating resulted in shorter operative times and less blood loss. More patients with the percutaneous compression plate were able to walk independently, they had consistently lower levels of pain with activity and improved quality of life according to multiple scales of the Short Form-36,” the authors wrote. “However, these differences did not reach significance.”