Resorbable cement for the augmentation of internally

The Journal of Bone and Joint Surgery (Br) 87-B: 1203-1209, 2005
Resorbable cement for the augmentation of internally-fixed unstable
trochanteric fractures
A prospective, randomised multicentre study
P. Mattsson, MD*, A. Alberts, MD, PhD, G. Dahlberg, MD, M. Sohlman, MD,
H.C. Hyldahl, MD, PhD, and S. Larsson, PhD, MD
要 約:
We undertook a multicentre, prospective study of a series of 112 unstable trochanteric fractures in order to
evaluate if internal fixation with a sliding screw device
combined with augmentation using a calcium phosphate
degradable cement (Norian SRS) could improve the
clinical, functional and radiological outcome when compared with fractures treated with a sliding screw device
alone. Pain, activities of daily living, health status (SF36), the strength of the hip abductor muscles and radiological outcome were analysed.
Six weeks after surgery, the patients in the augmented
group had significantly lower global and functional pain
scores (p < 0.003), less pain after walking 50 feet (p <
0.01), and a better return to the activities of daily living
(p < 0.05). At follow-up at six weeks and six months,
those in the augmented group showed a significant improvement compared with the control group in the SF36 score. No other significant differences were found
between the groups. We conclude that augmentation with
calcium phosphate cement in unstable trochanteric fractures provides a modest reduction in pain and a slight
improvement in the quality of life during the course of
healing when compared with conventional fixation with
a sliding screw device alone.
大腿骨転子部不安定性骨折患者 112 例を対象として前
(Norian SRS)
による補強と sliding screw
の併用により内固定術を行った場合,sliding screw のみ
で治療した骨折例と比較して,臨床的,機能的,X 線学
,股関節外転筋の筋力,X 線学的
術後 6 週目では,補強群のほうが,全体的スコアと機
,50 フィート歩
.6 週目および 6 ヵ月目の追
跡評価において,補強群の SF-36 スコアには対照群より
も有意な改善が認められた.その他の項目については 2
うと,sliding screw のみを用いる従来の固定術と比較し
て,骨折治癒の過程で疼痛に軽度の改善と,QOL にわず
*Department of Orthopaedics, Uppsala University Hospital,
S-75185 Uppsala, Sweden.
Reproduced with permission and copyright of The British Editorial Society of Bone and Joint Surgery [J Bone Joint Surg Br. 2005; 87: 1204]