Short versus long proximal femoral nail in the management of intertrochanteric fractures - a comparative study.

IF 1.4 Q3 EMERGENCY MEDICINE
Mohamed Arshad K Rahman, Yasir S Siddiqui, Mohammad Julfiqar, Abdul Q Khan, Aamir B Sabir, Mazhar Abbas
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引用次数: 0

Abstract

Introduction: Intertrochanteric fractures are those that occur in the region spanning from the extracapsular basilar neck region to the region along the lesser trochanter proximal to the development of medullary canal. Low-energy falls account for 90% of fractures in people over the age of 50, with females having a higher prevalence. Intertrochanteric fractures in children and teenagers are caused by high-energy trauma. The aim of this study was to compare the functional and radiological outcomes as well as complications of intertrochanteric fractures treated with long proximal femoral nail (PFN) versus short proximal femoral nails.

Methods: The study was a clinical randomized prospective comparative study which included 30 (2 groups of 15 patients each, being treated with short and long PFNs respectively) skeletally mature patients with fresh (less than 3 weeks old) intertrochanteric fractures of femur AO/OTA 31-A1, AO/OTA 31-A2 or AO/OTA 31-A3 as per AO/OTA classification. Harris Hip score was used to compare the functional outcomes.

Results: The average age of patients in short PFN group (Group A) was 62.1 ± 15.77 years and in long PFN group (Group B), it was 54.1 ± 10.8 years. Male-female ratio in the study was 1.7:1. AO31A2 of AO fracture classification was the most common type of fracture in both the groups. The mean injury to surgery interval in Group A was 9.6 ± 4.45 days and in Group B, it was 6 ± 4.12 days. The mean operative duration in Group A was 68.6 ± 6.62 minutes and in Group B, it was 78.6 ± 7.35 minutes. The average time of union in Group A was 15.69 ± 2.72 weeks while that of Group B was 15.77 ± 2.05 weeks. The average Harris Hip score at final follow up in Group A was 81.0 ± 11.62 and in Group B, it was 80.3 ± 10.83. There was 1 case of implant failure in each group, which were re-operated. One case of screw back-out in Group A led to a varus collapse and had to be reoperated. One case of non-union was reported in Group B. One case of superficial wound infection was reported in each group.

Conclusion: The Proximal Femur Nail can be used as an efficient implant to manage per trochanteric fractures regardless of the length of the implant. However, the mean operative time was found to be lower when a short nail is used.

股骨近端短钉与长钉治疗粗隆间骨折的比较研究。
简介:股骨粗隆间骨折发生在基底颈囊外至沿小粗隆近端髓管发育的区域。低能量跌倒占50岁以上人群骨折的90%,其中女性发病率更高。儿童和青少年的转子间骨折是由高能创伤引起的。本研究的目的是比较股骨近端长钉(PFN)与股骨近端短钉治疗股骨粗隆间骨折的功能和放射学结果以及并发症。方法:本研究是一项临床随机前瞻性比较研究,纳入30例(2组各15例,分别使用短PFNs和长PFNs治疗)骨骼成熟的新鲜(小于3周)股骨粗隆间骨折(AO/OTA 31-A1、AO/OTA 31-A2或AO/OTA 31-A3),按AO/OTA分类。Harris髋关节评分用于比较功能结果。结果:短PFN组(A组)患者平均年龄为62.1±15.77岁,长PFN组(B组)患者平均年龄为54.1±10.8岁。研究中的男女比例为1.7:1。AO骨折分型中的AO31A2是两组中最常见的骨折类型。A组平均损伤至手术时间为9.6±4.45 d, B组平均损伤至手术时间为6±4.12 d。A组平均手术时间为68.6±6.62 min, B组平均手术时间为78.6±7.35 min。A组平均愈合时间15.69±2.72周,B组平均愈合时间15.77±2.05周。末次随访时,A组Harris髋关节平均评分为81.0±11.62,B组平均评分为80.3±10.83。两组各有1例种植体失败,均行再手术治疗。A组1例螺钉退出导致内翻塌陷,需再次手术。b组报告1例伤口不愈合,每组报告1例浅表伤口感染。结论:股骨近端钉可作为一种有效的内固定治疗股骨粗隆骨折,与内固定长度无关。然而,当使用短钉时,发现平均手术时间较短。
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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