Clinical application and effectiveness analysis of the InterTan nail in the treatment of femoral neck fractures.

IF 2 3区 医学 Q3 ORTHOPEDICS
Hao Liu, Jiliang He, Mingyu Li, Quansah Augustine, Pingshan Wang, Xiaosong Liu, Xiangquan Chu
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引用次数: 0

Abstract

Objectives: To evaluate the clinical and radiographic outcomes of the InterTan nail as a stand-alone internal fixation device for predominantly high-energy displaced femoral neck fractures in younger and middle-aged adults.

Methods: Design: Retrospective case series.

Setting: Single-center study at a tertiary trauma hospital in China.

Patient selection criteria: Patients aged ≤65 years with isolated, unilateral femoral neck fractures (OTA/AO 31B) treated with InterTan nail fixation between January 1, 2017, and January 1, 2022, were included. Patients with local infection or inflammation, open or pathological fractures, multiple fractures, severe systemic comorbidities precluding surgery, or psychiatric or neuromuscular disorders that could predispose to fixation failure or postoperative complications were excluded.

Outcome measures and comparisons: Outcomes included reduction quality, fracture union, femoral neck shortening, complications, reoperation, Harris Hip Score, pain, and postoperative weight-bearing progression.

Results: Twenty-five patients were included; mean age was 50.0 ± 13.2 years (range, 17-65 years), and 8 (32.0%) were female. Mean follow-up was 34.6 ± 17.6 months (range, 24-84 months). Twenty-one fractures (84.0%) were Pauwels type III and 21 (84.0%) were Garden type III or IV. All patients achieved acceptable reduction, defined as a Garden Alignment Index of 155°-180° on anteroposterior radiographs, and all fractures achieved union. Mean femoral neck shortening was 1.7 ± 1.9 mm (range, 0-7.3 mm). At 24 months, mean Harris Hip Score was 90.8 ± 6.2. One patient (4.0%) underwent reoperation for osteonecrosis of the femoral head within 2 years postoperatively.

Conclusions: In patients aged ≤65 years with predominantly high-energy displaced femoral neck fractures, InterTan nail fixation following acceptable reduction was associated with fracture union in all patients, and a 4.0% reoperation rate within 2 years. These findings supported InterTan nail fixation as a potential fixation option for this specific patient population.

Level of evidence: Level IV.

InterTan内钉治疗股骨颈骨折的临床应用及疗效分析。
目的:评价InterTan钉作为独立内固定装置治疗中青年高能量移位型股骨颈骨折的临床和影像学结果。方法:设计:回顾性病例系列。背景:在中国某三级创伤医院进行单中心研究。患者选择标准:纳入2017年1月1日至2022年1月1日期间接受InterTan钉固定治疗的年龄≤65岁的孤立单侧股骨颈骨折(OTA/AO 31B)患者。排除了有局部感染或炎症、开放性或病理性骨折、多发骨折、严重的系统性合并症而不能手术的患者,或易导致固定失败或术后并发症的精神或神经肌肉疾病患者。结果测量和比较:结果包括复位质量、骨折愈合、股骨颈缩短、并发症、再手术、Harris髋关节评分、疼痛和术后负重进展。结果:纳入25例患者;平均年龄50.0±13.2岁(17 ~ 65岁),女性8例(32.0%)。平均随访34.6±17.6个月(范围24 ~ 84个月)。21例(84.0%)为Pauwels III型骨折,21例(84.0%)为Garden III型或IV型骨折。所有患者均获得可接受的复位,定义为正位片上Garden对准指数为155°-180°,所有骨折均愈合。股骨颈平均缩短1.7±1.9 mm(范围0-7.3 mm)。24个月时Harris髋关节评分为90.8±6.2。1例(4.0%)术后2年内因股骨头骨坏死再次手术。结论:在年龄≤65岁以高能量移位型股骨颈骨折为主的患者中,所有患者接受复位后的InterTan钉内固定均与骨折愈合相关,2年内再手术率为4.0%。这些发现支持InterTan甲内固定作为这一特定患者群体的潜在固定选择。证据等级:四级。
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
Journal of Orthopaedic Trauma
Journal of Orthopaedic Trauma 医学-运动科学
CiteScore
3.90
自引率
8.70%
发文量
396
审稿时长
3-8 weeks
期刊介绍: Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.
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