Fixation of AO-OTA 31-A1 and A2 trochanteric femur fractures using a sliding hip screw system: can we trust a two-hole side plate construct? A review of the literature.

Wagman et al noted in a retrospective study of 349 trochanteric fractures that serum creatine phosphokinase (CPK) levels as a biochemical marker of soft tissue injury were higher in DHS patients than in PFN patients on post-operative day one, that post-operative haemoglobin decrease was greater in PFN patients probably due to the reaming process (this difference did not reach statistical significance) and that post-operative C-reactive protein (CRP) levels were not statistically significantly different between patient groups. 31 The surgical technique used for DHS implantation involved a 7 to 10 cm long approach; this implies that a DHS with more than two holes was used, presumably a four-hole DHS, and that a muscle-reflecting approach rather than a minimally invasive muscle-splitting approach was used.

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