Table 3 Details of all reoperations (n = 20) and analysis of mechanisms of technical complications in treatment protocol: Medoff sliding plate/dynamic hip screw
Fracture type | Fixation | Analysis of mechanism | Reflection on mechanism of complication | Reoperation | Technical complication category | Surgeon’s experiencea | Fracture reduction | Twin hook/lag screw position | Outcomeb |
|---|---|---|---|---|---|---|---|---|---|
JM5 | MSP uniaxial | Sliding plate consumed | In line with treatment protocol | Locking screw removed | No; adjustment | 2 | Acceptable | Good | Fracture healing |
SH2C | 3 | ||||||||
SH3A | 4 | Good | |||||||
SH5 | 1 | ||||||||
SH5 | 2 | Acceptable | |||||||
SH5 | 3 | ||||||||
SH5 | 2 | Poor | |||||||
JM5 | MSP biaxial | Intraoperative error -TH wing in hip joint | Avoidable | TH replaced | Minor | 3 | Poor | To distal | Fracture healing |
JM5 | MSP uniaxial | TH penetration – sliding plate consumed, but locking screw not removed | Locking screw should have been removed postoperatively, since plate sliding capacity was consumed | TH replaced locking screw removed | Minor | 2 | Poor | Good | Fracture healing |
JM5 | 4 | Good | |||||||
SH2C | 2 | ||||||||
SH5 | 3 | ||||||||
SH3A | 3 | Acceptable | |||||||
SH3A | 4 | ||||||||
JM3 | DHS | Medialisation and varus dislocation | DHS allowed anteromedialisation due to lack of lateral/posterior support | Hip joint replacement | Major | 1 | Good | Good | Hip joint replacement |
JM5 | MSP biaxial | TH penetration –medialisation | MSP should have been locked. Biaxial MSP allowed anteromedialisation due to lack of lateral/posterior support | MSP biaxial replaced with MSP uniaxial | Intermediate | 3 | Acceptable | Good | Fracture healing |
JM5 | Medialisation and varus dislocation | Hip joint replacement | Major | 4 | Good | Hip joint replacement | |||
JM2 | DHS | Varus dislocation and cut-out | Fracture impaction occured - DHS load-sharing was insufficient with unloading of fracture site | Hip joint replacement | Major | 2 | Good | Posterior | Hip joint replacement |
SH5 | IMN | Nonunion with broken IMN | IMN was load-bearing with unloading of fracture site and with stress concentration | IMN replaced with uniaxial MSP | Intermediate | 4 | Acceptable | Good | Fracture healing |