Outcomes of SIGN Hip Constructs Among Patients Treated at Kumi Orthopaedic Center
John Ekure, Naomi Amuron, Douglas Kilama, Phillip Buluma, Bashir Masembe, Saviour Kicaber, Faith Akello.
Introduction: Hip fracture rates in Africa are expected to rise significantly over the next years. This is largely due to the aging population and the associated rise in the prevalence of osteoporosis. Hip fractures have the greatest health and economic impact. The Surgical Implant Generation Network (SIGN) Hip Construct was developed to treat patients with hip fractures without the aid of fluoroscopic imaging. This has been used on a number of patients in Uganda. However, there is no documentation of the longterm outcomes following fixation with these Hip constructs in Uganda.
Methods: This was a retrospective analysis of 11 patients that had been treated using SIGN hip construct from 2009 to 2019 using the SIGN online surgical database. Patients with a follow-up greater than 12 weeks and adequate radiographs were included. Data analyzed included the patient socio-demographics, clinical characteristics and surgical outcomes.
Results: Eleven patients were analyzed, eight males and three females with a mean age of 57.7 years (±25.7). Majority, 8(72.7%), had intertrochanteric fractures and classified as 31A3 6(54.6%) according to AO classification. During surgery 8(72.7%) had a side plate used.
On follow up, the median follow-up period was 4 months (IQR: 3-72 months) with a range of 3 to 72 months. The success rate following clinical assessment of squat and smile was 81.8%. On radiological assessment 8 (72.7%) had healing on x-ray while 3 (27.3%) did not show healing on x-ray. Of those that did not show healing on x-ray, 1 had early implant failure, another one had proximal nail migration 4 months later and another had an early varus fracture collapse after 2 months. There was no case of malunion noted following fixation using the hip constructs.
Conclusion: The SIGN hip construct can be used comfortably and with ease to fix fractures of the proximal femur in the absence of intraoperative image intensifiers. It offers acceptable clinical and radiological outcomes.
