Advantages of Distal Unlocked Proximal Femoral Nails in the Treatment of Stable Intertrochanteric Fractures in Geriatric Patients: A Single-Center Comparative Randomized Study.

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY

Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2025-03-28 eCollection Date: 2025-01-01 DOI:10.1177/21514593251327910

Sönmez Sağlam, Omer Ersen, Harun Yasin Tüzün, Cemil Yıldız

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引用次数: 0

Abstract

Background: This study aimed to investigate the effect of omitting a distal locking screw in intramedullary nailing of stable intertrochanteric femur fractures on clinical outcomes.

Methods: Ninety-six patients over 65 years old with stable pertrochanteric fractures (AO/OTA 31-A1 and A2) treated with short/intermediate proximal femoral nails (PFNA-II) were randomly assigned into two groups: Group 1 (distal locked) and Group 2 (distal unlocked). Comparative analyses were conducted on operative time, total fluoroscopy time, blood loss, incision length, complications, and functional outcomes.

Results: The mean operative time was significantly shorter in Group 2 (35.73 ± 7.62 minutes) compared to Group 1 (47.40 ± 9.96 minutes) (P < 0.001). Fluoroscopy time was also shorter in Group 2 (45.92 ± 6.08 seconds) compared to Group 1 (54.02 ± 5.94 seconds) (P < 0.001). Incision length was reduced in Group 2 (9.21 ± 1.41 centimeters) compared to Group 1 (12.96 ± 1.68 centimeters) (P < 0.001). Blood loss was lower in Group 2 (187.50 ± 32.00 milliliters) than in Group 1 (208.65 ± 49.12 milliliters) (P < 0.05). There were no significant differences between the groups in fracture union time, hospital stay, fracture union weeks, or postoperative blood transfusion rates.

Conclusions: Proximal femoral nailing without distal locking offers shorter operative times, reduced fluoroscopy exposure, and lower blood loss and complications, making it a viable option for treating stable intertrochanteric fractures.

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远端未锁定股骨近端钉治疗老年患者稳定转子间骨折的优势：一项单中心比较随机研究。

背景：本研究旨在探讨在稳定股骨粗隆间骨折髓内钉治疗中省略远端锁定螺钉对临床预后的影响。方法：96例65岁以上稳定股骨粗隆骨折（AO/OTA 31-A1和A2）患者采用短/中股骨近端钉（PFNA-II）治疗，随机分为2组：1组（远端锁定）和2组（远端解锁）。对比分析手术时间、全透视时间、出血量、切口长度、并发症和功能结局。结果：2组平均手术时间（35.73±7.62 min）明显短于1组（47.40±9.96 min）（P < 0.001）。2组透视时间（45.92±6.08秒）短于1组（54.02±5.94秒）（P < 0.001）。2组切口长度（9.21±1.41 cm）较1组（12.96±1.68 cm）缩短（P < 0.001）。出血量2组（187.50±32.00 ml）低于1组（208.65±49.12 ml）（P < 0.05）。两组间骨折愈合时间、住院时间、愈合周数、术后输血率均无显著差异。结论：股骨近端内钉无需远端锁定可缩短手术时间，减少透视暴露，减少出血量和并发症，使其成为治疗稳定转子间骨折的可行选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geriatric Orthopaedic Surgery & Rehabilitation Medicine-Rehabilitation

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).