Is the lag screw sliding effective in the intramedullary nailing in A1 and A2 AO-OTA intertrochanteric fractures? A prospective study of Sliding and None-sliding lag screw in Gamma-III nail
| Autor: | Yi Zhu, Congfeng Luo, Severin Meili, Changqing Zhang, Bingfang Zeng |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Intertrochanteric fractures
China medicine.medical_specialty Bone Screws Healing time Bone healing Bone Nails Critical Care and Intensive Care Medicine Statistics Nonparametric law.invention Intramedullary rod Lag screw law Outcome Assessment Health Care Fracture fixation medicine Humans Prospective Studies Prospective cohort study Original Research Chi-Square Distribution Gamma nail Hip Fractures business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 Lag screw sliding A1 and A2 AO-OTA Fracture Fixation Intramedullary Surgery medicine.anatomical_structure Nail (anatomy) Emergency Medicine business |
| Zdroj: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 20, Iss 1, p 60 (2012) |
| ISSN: | 1757-7241 |
| DOI: | 10.1186/1757-7241-20-60 |
| Popis: | ObjectTo compare the Sliding with Non-sliding lag screw of a gamma nail in the treatment of A1 and A2 AO-OTA intertrochanteric fractures.Materials and methods80 patients were prospectively collected. In each group, AO/OTA 31-A were classified into group A. AO/OTA 31-A2.1 was classified as group B. We classified the A2.2 and A2.3 as group C. According to the set-screw locking formation of Gamma-III, the cases were randomly allocated to Sliding subgroup and Non-sliding subgroup in A, B and C groups. Follow-ups were performed 1, 3, 6 and 12 months postoperatively.ResultsIn the Sliding group, the bone healing rate 3, 6, 12 months postoperatively reached 85.00%, 97.50%, 100% in group A, B and C. Meanwhile, in Non-sliding group, postoperatively, bone healing rate were 90.00%, 95.00% and 97.50% in group A, B and C, respectively. Both differences were not significant. Lower limb discrepancy between Sliding and Non-sliding pattern was significantly different in group C which represent fracture types of AO/OTA 31-A2.2 and A2.3 (0.573 ± 0.019 mm in Non-sliding group, 0.955 mm ± 0.024 mm in Sliding group, P < 0.001 ). Difference of sliding distance among the three groups was significant among group A, B and C: 0.48 mm ± 0.04 mm, 0.62 mm ± 0.07 mm and 0.92 mm ± 0.04 mm (P < 0.001). Differences in average healing time and Harris scores also presented no significance in the three groups.ConclusionsAs a result, we can conclude that the sliding distance is minimal in Gamma nails and it is related to the comminuted extent of the intertrochanteric area in A1 and A2 AO-OTA intertrochanteric fractures. For treating these kinds of fractures, the sliding of the lag screw of an Gamma nail does not improve any clinical results and in certain cases, such as highly comminuted A1 and A2 fractures, can therefore even benefit from a locked lag screw by tightening the set-screw. |
| Databáze: | OpenAIRE |
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