Comparison between locked and unlocked intramedullary nails in intertrochanteric fractures
| Autor: | Olga Bisaccia, Daniele Maiettini, Michele Scialpi, Michele Bisaccia, Cristina Ibáñez Vicente, Giulio Gambaracci, Francesco Manfreda, Paolo Ceccarini, Riccardo Maria Lanzetti, Giuseppe Rinonapoli, Auro Caraffa, Domenico Lupariello, Luigi Meccariello |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Radiography Bone Screws Operative Time Blood Loss Surgical Bone healing Bone Nails Prosthesis Design Radiation Dosage law.invention Intramedullary rod 03 medical and health sciences Postoperative Complications 0302 clinical medicine Blood loss law Fracture fixation medicine Humans Fluoroscopy Blood Transfusion Orthopedics and Sports Medicine 030212 general & internal medicine Prospective cohort study Aged Aged 80 and over Postoperative Care 030222 orthopedics medicine.diagnostic_test Hip Fractures business.industry Middle Aged Fracture Fixation Intramedullary Surgery Treatment Outcome Harris Hip Score Female business |
| Zdroj: | European Journal of Orthopaedic Surgery & Traumatology. 28:649-658 |
| ISSN: | 1432-1068 1633-8065 |
| DOI: | 10.1007/s00590-018-2143-9 |
| Popis: | Intertrochanteric fractures are of great interest worldwide and are the most frequently operated fractures. Intramedullary nailing is commonly used in the treatment of intertrochanteric fractures. The purpose of this study is to assess the necessity of using the distal blocking screw in 31-A1 and 31-A2 fractures, classified according to the Orthopaedic Trauma Association classification system (AO/OTA). This is a prospective study of 143 consecutive patients (mean age 85.01 years, mean final follow-up 14.1 months) surgically treated with the same intramedullary nail. In 75 cases, the distal locking screw was not used. Parameters evaluated during follow-up were: blood loss, transfusion requirements, surgery duration, and fluoroscopy time. Harris Hip Score and Barthel Activity Daily Living were used for the clinical evaluation. Radiographic Union Score For Hip (RUSH score) and Tip apex distance (TAD) were measured for radiologic evaluation. The group treated without locking screw showed significantly shorter surgical duration time (31.9 vs. 47.2 min), a decrease in blood loss (variation Hb − 1.06 vs. − 1.97), and reduced X-rays exposure time (25.4 vs. 31.6 s). No significant differences were observed in the postoperative period and in the radiographic and clinical scores. This study demonstrates that in intertrochanteric 31-A1 and 31-A2 stable fractures, the absence of distal locking screw does not compromise bone healing and prevents several clinical complications. |
| Databáze: | OpenAIRE |
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