Abstract
Objective To compare the techniques for the osteosynthesis of intertrochanteric fractures with
dynamic hip screws (DHSs) through the Hardinge and minimally-invasive access routes
of the hip, evaluating the operative time, the degree of pain in the immediate postoperative
period, the hematimetric loss, and the functional aspects of active mobility.
Methods A randomized, double-blinded clinical trial in which 66 patients with intertrochanteric
fractures were submitted to osteosynthesis by DHS. The patients were divided into
a test group, submitted to the minimally-invasive access, and a control group, in
whom the surgery was performed through the Hardinge route.
Results Patients submitted to the minimally-invasive treatment presented a lower degree of
postoperative pain compared to the group treated by the Hardinge lateral route (p < 0.001), as well as lower hematimetric loss (p < 0.001), shorter operative time (p < 0.001), and improvement in immediate postoperative active mobility tests (p <0.05).
Conclusion The study demonstrated the clinical superiority of the minimally-invasive access
route parameters analyzed in relation to the Hardinge access for the fixation of intertrochanteric
fractures when DHS is the choice osteosynthesis method.
Level of evidence I.
Keywords
intertrochanteric fracture - minimally-invasive surgical procedures - osteosynthesis
- pain, postoperative - clinical trial
