Fixation of intertrochanteric femur fractures using the SIGN intramedullary nail augmented by a lateral plate in a resource-limited setting without intraoperative fluoroscopy: assessment of functional outcomes at one-year follow-up at Juba Teaching Hospital.

Autor:	Areu MMM; Department of Orthopedic and Traumatology, University of Juba (UOJ), Juba, South Sudan., von Kaeppler EP; Department of Surgery, University of California San Francisco, San Francisco, CA., Madison BB; Department of Orthopedic and Traumatology, University of Juba (UOJ), Juba, South Sudan., Aguto AA; Department of Orthopedic and Traumatology, University of Juba (UOJ), Juba, South Sudan., Alphones J; Department of Orthopedic and Traumatology, University of Juba (UOJ), Juba, South Sudan., Zirkle LG; Department of Orthopedics, Kadlec Regional Medical Center, Richland, WA, USA., Morshed S; Department of Surgery, University of California San Francisco, San Francisco, CA., Shearer DW; Department of Surgery, University of California San Francisco, San Francisco, CA.
Jazyk:	angličtina
Zdroj:	OTA international : the open access journal of orthopaedic trauma [OTA Int] 2021 Jul 16; Vol. 4 (3), pp. e133. Date of Electronic Publication: 2021 Jul 16 (Print Publication: 2021).
DOI:	10.1097/OI9.0000000000000133
Abstrakt:	Objectives: The incidence of hip fracture is high and increasing globally due to an aging population. Morbidity and mortality from these injuries are high at baseline and worse without prompt surgical treatment to facilitate early mobilization. Due to resource constraints, surgeons in low-income countries often must adapt available materials to meet these surgical needs. The objective of this study is to assess functional outcomes after surgical fixation of intertrochanteric femur fractures with the Surgical Implant Generation Network (SIGN) intramedullary nail augmented by a lateral SIGN plate. Design: Prospective case series. Setting: Juba Teaching Hospital, Tertiary Referral Hospital for South Sudan. Participants: Adult patients with intertrochanteric hip fractures. Intervention: SIGN nail augmented by a lateral plate. Main Outcome Measurements: Primary outcome was hip function as measured by a modified Harris Hip Score (mHHS) at 1-year after surgery. Secondary endpoints were the occurrence of reoperation or infection at 1-year after surgery. Results: Thirty patients were included, 16 (53%) men and 14 (47%) women, with a mean age of 62 years. Fractures were classified as AO/OTA Type 31A1 in 12 (40%) patients, 31A2 in 15 (50%) patients, and 31A3 in 3 (10%) patients. Mean mHHS at 1-year was 75.10 ± 21.2 with 76% categorized as excellent or good scores. There was 1 (3%) infection and 2 (7%) reoperations. Conclusions: The SIGN nail augmented by a lateral plate achieved good or excellent hip function in the majority of patients with intertrochanteric hip fractures. This may be a suitable alternative to conventional implants for hip fracture patients in low-resource settings to allow mobilization. Competing Interests: LZ is president and founder of SIGN Fracture Care International. DS serves as vice president of SIGN Fracture Care International. No other authors have any conflicts of interests to disclose. (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)
Databáze:	MEDLINE
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