Traumax screw plate vs. Gamma nail. Blood loss in pertrochanteric fractures treated by minimally invasive osteosynthesis

International audiencePURPOSE:This study is aimed to determine whether the Traumax dynamic hip screw reduces perioperative blood loss and transfusion rate compared to the Gamma nail in the treatment of pertrochanteric fractures.MATERIALS AND METHODS:A series of 331 patients were followed prospectively in a cohort study between February 2008 and October 2011 after a pertrochanteric fracture. Two types of fixation were used, 163 patients were treated with a Gamma nail and 168 patients with a minimally invasive screw plate Traumax. Perioperative blood loss, evaluated by the Mercuriali formula based on pre- and postoperative haemoglobin and transfusion rates were compared in order to assess risk factors.RESULTS:Increased perioperative blood loss was significantly linked with patient-related parameters (age, anticoagulant and platelet aggregation inhibitor treatment). Type of osteosynthesis and type of fracture were also risk factors for blood loss and transfusion. The Traumax group had significantly lower blood loss (347 ml vs. 577 ml) and transfusion rate (33.9% vs. 63.8%) than the Gamma group. Involvement of the greater trochanter increased the risk of blood loss only in the Gamma group. Functional results and bone healing were comparable at six months follow-up.CONCLUSION:Screw plate Traumax significantly reduces perioperative bleeding after pertrochanteric fractures. It avoids fracture gaps that tend to maintain bleeding. Given the morbidity and complications related to acute anaemia and blood transfusion, the surgical management of these elderly patients is aided by this choice of fixation

Building Satisfaction and Loyalty During a Musical Benefit Event: A Consumer-Based Approach

This research addresses the respective importance of the charitable, experiential, and service-based dimensions associated with benefit concerts. Through a consumer-based approach, we examine the effects of three antecedents (charitable scope, immersion, and quality of service) on satisfaction and behavioral outcomes (loyalty and positive word-of-mouth). Data collected on site immediately after a charity concert are analyzed with structural equation modeling. The state of immersion and the event’s charitable scope enhance the overall satisfaction, which, in turn, fosters the behavioral outcomes. Direct effects are identified; satisfaction is influenced more by immersion, whereas behavioral outcomes depend more on charitable scope. The type of initial motivation moderates the findings: The quality of service enhances satisfaction only among attendees with other-focused motivation, immersion improves satisfaction if the motivation is self-focused, and charitable scope remains an important factor of satisfaction regardless of the type of motivation