Risk factors for intramedullary nail breakage in proximal femoral fractures: a 10-year retrospective review
| Autor: | A. V. Kulkarni, J.N. Davison, N.A. Johnson, C.E. Uzoigwe, Venkatesan M, Burgula, Ashford Ru |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Dentistry Bone Nails law.invention Intramedullary rod 03 medical and health sciences Fixation (surgical) Postoperative Complications 0302 clinical medicine Breakage law medicine Humans 030212 general & internal medicine Trauma and Orthopaedic Surgery Aged Retrospective Studies Aged 80 and over 030222 orthopedics Retrospective review Proximal femur business.industry Mean age General Medicine Middle Aged Fracture Fixation Intramedullary Surgery Equipment Failure Female Complication business Femoral Fractures American society of anesthesiologists |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 99:145-150 |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/rcsann.2016.0297 |
| Popis: | INTRODUCTION Intramedullary nailing is a common treatment for proximal femoral fractures. Fracture of the nail is a rare but devastating complication that exposes often frail patients to complex revision surgery. We investigated which risk factors predict nail failure. METHODS We reviewed all cases of nail breakage seen over a 10-year period in a single busy trauma unit; 22 nail fractures were seen in 19 patients. Comparison was made with a group of 209 consecutive patients who underwent intramedullary fixation of a proximal femur fracture with no nail breakage over a 2-year period. RESULTS In the fractured nail group, mean age was 70.4 years (range 55–88 years).The mean time to fracture was 10 months (range 2.5–23 months). Logistical regression was used to show that low American Society of Anesthesiologists (ASA) score, subtrochanteric fracture and pathological fracture were independent risk factors for nail fracture. CONCLUSIONS Young patients with a low ASA score are at highest risk of nail breakage. We advise close follow-up of patients with these risk factors until bony union has been achieved. In addition, there may be merit in considering other treatment options, such as proximal femoral replacement, especially for those with pathological fracture with a good prognosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|