A. Ebrahimpour, A. Karimi, M. Sadighi, M. Sajjadi, M. Okhovatpour, A. Irani, R. Zandi
{"title":"动力髋螺钉治疗股骨粗隆间骨折术后中心-粗隆距离(CTD)和尖端距离(TAD)变化的相关性","authors":"A. Ebrahimpour, A. Karimi, M. Sadighi, M. Sajjadi, M. Okhovatpour, A. Irani, R. Zandi","doi":"10.30491/TM.2019.104271","DOIUrl":null,"url":null,"abstract":"Background: One of the most common injuries and an important cause of mortality and morbidity in the elderly is intertrochanteric fracture. The dynamic hip screw (DHS) is one of the best procedures for fixation of these fractures; however, using DHS is accompanied by failure risk. Objectives: Therefore, with the purpose of reducing failure risk, this study aimed to evaluate the correlation between post-operation CTD and TAD, NSA changes in patients with intertrochanteric fractures. Methods: In this case series study, patients with intertrochanteric fracture treated with DHS between September 2015 and January 2016 were included. The exclusion criteria were pathologic fracture, multiple fractures, greater trochanter fracture, soft-tissue issues, A3OTA type, patients who missed the follow-up period, history of previous hip fracture or dislocation, and TAD>25mm. Ultimately, 24 patients were included in this study. Two surgeons reviewed the anteroposterior (AP) and lateral (Lat) radiographs. The measures of TAD, CTD, and NSA after six-months of follow-up were assessed. In addition, variables such as demographic data, fracture side, duration of operation, blood loss volume, weight bearing day, and Harris hip score (HHS) were analyzed. The relationship between post-operation CTD and TAD, NSA changes after six months of follow-up was analyzed. All data was analyzed using SPSS 20 software (SPSS, IBM Inc., USA). The significance level for all tests was considered to be 0.05. Results: This study evaluated 24 patients. The mean age of the patients was 69.9 ± 12.00 years, and 15 (62.5%) of them were male. No significant correlations were seen in the collected data, especially CTD and NSA changes after six-months of follow-up (p>0.05). Maximum and minimum TAD values after surgery were 25.6 and 11.0, respectively. Maximum and minimum TAD values at the six-month follow-up were 34.9 and 11.0, respectively. Mean TAD was constant at 19.8±5.3 in postoperative and follow-up measurements. This shows that patients experienced increases in TAD and others experienced decreases in TAD within the six months of follow-up. Conclusion: The results showed that despite the abnormal CTD after surgery, the risk of TAD changes increased. Generally, TAD is a well-established radiographic measurement for predicting the risk of cut-out. CTD and TAD can be used together or separately to predict the risk of DHS screw cut-out in patients with intertrochanteric fractures in future studies.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation between Post-Operation Center-Trochanteric Distance (CTD) and Tip Apex Distance (TAD) changes in Intertrochanteric Fractures Treated by Dynamic Hip Screw\",\"authors\":\"A. Ebrahimpour, A. Karimi, M. Sadighi, M. Sajjadi, M. Okhovatpour, A. Irani, R. Zandi\",\"doi\":\"10.30491/TM.2019.104271\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: One of the most common injuries and an important cause of mortality and morbidity in the elderly is intertrochanteric fracture. The dynamic hip screw (DHS) is one of the best procedures for fixation of these fractures; however, using DHS is accompanied by failure risk. Objectives: Therefore, with the purpose of reducing failure risk, this study aimed to evaluate the correlation between post-operation CTD and TAD, NSA changes in patients with intertrochanteric fractures. Methods: In this case series study, patients with intertrochanteric fracture treated with DHS between September 2015 and January 2016 were included. The exclusion criteria were pathologic fracture, multiple fractures, greater trochanter fracture, soft-tissue issues, A3OTA type, patients who missed the follow-up period, history of previous hip fracture or dislocation, and TAD>25mm. Ultimately, 24 patients were included in this study. Two surgeons reviewed the anteroposterior (AP) and lateral (Lat) radiographs. The measures of TAD, CTD, and NSA after six-months of follow-up were assessed. In addition, variables such as demographic data, fracture side, duration of operation, blood loss volume, weight bearing day, and Harris hip score (HHS) were analyzed. The relationship between post-operation CTD and TAD, NSA changes after six months of follow-up was analyzed. All data was analyzed using SPSS 20 software (SPSS, IBM Inc., USA). The significance level for all tests was considered to be 0.05. Results: This study evaluated 24 patients. The mean age of the patients was 69.9 ± 12.00 years, and 15 (62.5%) of them were male. No significant correlations were seen in the collected data, especially CTD and NSA changes after six-months of follow-up (p>0.05). Maximum and minimum TAD values after surgery were 25.6 and 11.0, respectively. Maximum and minimum TAD values at the six-month follow-up were 34.9 and 11.0, respectively. Mean TAD was constant at 19.8±5.3 in postoperative and follow-up measurements. This shows that patients experienced increases in TAD and others experienced decreases in TAD within the six months of follow-up. Conclusion: The results showed that despite the abnormal CTD after surgery, the risk of TAD changes increased. Generally, TAD is a well-established radiographic measurement for predicting the risk of cut-out. CTD and TAD can be used together or separately to predict the risk of DHS screw cut-out in patients with intertrochanteric fractures in future studies.\",\"PeriodicalId\":23249,\"journal\":{\"name\":\"Trauma monthly\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2019-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Trauma monthly\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.30491/TM.2019.104271\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Trauma monthly","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.30491/TM.2019.104271","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:股骨粗隆间骨折是老年人最常见的损伤之一,也是死亡率和发病率的重要原因。动态髋螺钉(DHS)是固定这些骨折的最佳方法之一;然而,使用DHS伴随着故障风险。目的:为了降低手术失败的风险,本研究旨在评价粗隆间骨折患者术后CTD与TAD、NSA变化的相关性。方法:本病例系列研究纳入2015年9月至2016年1月期间接受DHS治疗的股骨粗隆间骨折患者。排除标准为病理性骨折、多发骨折、大转子骨折、软组织问题、A3OTA型、错过随访期、既往髋部骨折或脱位史、TAD>25mm。最终,24名患者被纳入本研究。两位外科医生检查了正位(AP)和侧位(Lat) x线片。随访6个月后评估TAD、CTD、NSA指标。此外,还分析了人口统计学数据、骨折侧面、手术时间、出血量、负重日、Harris髋关节评分(HHS)等变量。术后随访6个月,分析CTD与TAD、NSA变化的关系。所有数据采用SPSS 20软件(SPSS, IBM Inc., USA)进行分析。所有检验的显著性水平被认为是0.05。结果:本研究评估了24例患者。患者平均年龄69.9±12.00岁,男性15例(62.5%)。随访6个月后CTD、NSA变化差异无统计学意义(p>0.05)。术后TAD最大值为25.6,最小值为11.0。6个月随访时最大TAD值为34.9,最小TAD值为11.0。术后和随访的平均TAD恒定在19.8±5.3。这表明,在六个月的随访中,患者的TAD增加,而其他人的TAD减少。结论:尽管术后CTD异常,但TAD改变的风险增加。一般来说,TAD是一种公认的用于预测切割风险的放射学测量方法。在未来的研究中,CTD和TAD可联合或单独用于预测股骨粗隆间骨折患者DHS螺钉切开的风险。
Correlation between Post-Operation Center-Trochanteric Distance (CTD) and Tip Apex Distance (TAD) changes in Intertrochanteric Fractures Treated by Dynamic Hip Screw
Background: One of the most common injuries and an important cause of mortality and morbidity in the elderly is intertrochanteric fracture. The dynamic hip screw (DHS) is one of the best procedures for fixation of these fractures; however, using DHS is accompanied by failure risk. Objectives: Therefore, with the purpose of reducing failure risk, this study aimed to evaluate the correlation between post-operation CTD and TAD, NSA changes in patients with intertrochanteric fractures. Methods: In this case series study, patients with intertrochanteric fracture treated with DHS between September 2015 and January 2016 were included. The exclusion criteria were pathologic fracture, multiple fractures, greater trochanter fracture, soft-tissue issues, A3OTA type, patients who missed the follow-up period, history of previous hip fracture or dislocation, and TAD>25mm. Ultimately, 24 patients were included in this study. Two surgeons reviewed the anteroposterior (AP) and lateral (Lat) radiographs. The measures of TAD, CTD, and NSA after six-months of follow-up were assessed. In addition, variables such as demographic data, fracture side, duration of operation, blood loss volume, weight bearing day, and Harris hip score (HHS) were analyzed. The relationship between post-operation CTD and TAD, NSA changes after six months of follow-up was analyzed. All data was analyzed using SPSS 20 software (SPSS, IBM Inc., USA). The significance level for all tests was considered to be 0.05. Results: This study evaluated 24 patients. The mean age of the patients was 69.9 ± 12.00 years, and 15 (62.5%) of them were male. No significant correlations were seen in the collected data, especially CTD and NSA changes after six-months of follow-up (p>0.05). Maximum and minimum TAD values after surgery were 25.6 and 11.0, respectively. Maximum and minimum TAD values at the six-month follow-up were 34.9 and 11.0, respectively. Mean TAD was constant at 19.8±5.3 in postoperative and follow-up measurements. This shows that patients experienced increases in TAD and others experienced decreases in TAD within the six months of follow-up. Conclusion: The results showed that despite the abnormal CTD after surgery, the risk of TAD changes increased. Generally, TAD is a well-established radiographic measurement for predicting the risk of cut-out. CTD and TAD can be used together or separately to predict the risk of DHS screw cut-out in patients with intertrochanteric fractures in future studies.