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Title: Mega-prosthetic Replacement Offers Advantages Over Standard Plate-and-Screw Treatment for Elderly Patients with Proximal Femoral Trauma: Presented at ACS

"Mega-prosthetic Replacement Offers Advantages Over Standard Plate-and-Screw Treatment for Elderly Patients with Proximal Femoral Trauma: Presented at ACS"

By John Otrompke CHICAGO, IL -- October 13, 2006 -- Patients with severe leg and hip bone injuries may be better served with primary mega-prosthetic replacement than with more conventional techniques, according to a study presented at the American College of Surgeons (ACS) 92[^nd Clinical Congress.

"In patients over the age of 75, many times a hip fracture is the sentinel event which leads to a downward spiral that ultimately leads to their death," said Andrew Schoenfeld, MD, orthopedic surgery resident, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio. Twenty to 40% of those 75 or over will die within 1 year of a fracture, Dr. Schoenfeld said.

Such patients typically survive surgery, but they can develop pressure ulcers, blood clots, and pneumonia, he said. Patients with open, complex fractures, in which the patient's bone penetrates the skin, are at even greater risk of delayed recovery.

"If they are treated with standard internal fixation devices, assuming no surgical complications, it would be at least 4 weeks before they could put normal weight on that leg," whereas with the primary mega-prosthetic replacement, "recovery is immediate. The day after surgery, the leg is full-weight-bearing, with no restrictions," Dr. Schoenfeld said.

In the primary mega-prosthesis method, the device manufactured by Stryker-Howmedica replaces the part of the femur bone that forms the hip, as well as the top of the femur shaft.

Dr. Schoenfeld presented a study on October 11^th, in which 10 patients with an average age of 76 years at Akron General Medical Center received mega-prostheses as principal treatment for their fractures.

During the average 44 months of follow-up, pain was absent in 5 of the 10 patients and the remainder reported occasional discomfort, without chronic or disabling pain, according to the abstract. One patient died postoperatively.

The study also compared patients first treated with primary mega-prosthesis versus those in whom standard therapies failed, who were then treated with mega-prosthesis. The results show that 44% of those in the revision group were pain free after surgery, Dr. Schoenfeld said.

[Presentation title: Primary Mega-Prosthetic Replacement Versus Salvage Mega-Prosthesis in the Treatment of Proximal Femoral Trauma.]

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