Does integrity of the lesser trochanter influence the surgical outcome of intertrochanteric fracture in elderly patients?
| Autor: | Shuo Pan, Yueju Liu, Dahai Yu, Huijian Cao, Xiaohui Liu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Sports medicine Operative Time Blood Loss Surgical Bone healing Bone Nails law.invention Intramedullary rod Postoperative Complications Rheumatology law Fracture fixation medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over Fracture Healing integumentary system business.industry Hip Fractures Age Factors Intramedullary nail Retrospective cohort study Recovery of Function Length of Stay Middle Aged R1 Surgery Biomechanical Phenomena Fracture Fixation Intramedullary Treatment Outcome Lesser Trochanter Orthopedic surgery Female Hip Joint Intertrochanteric fracture business Research Article Femoral intertrochanteric fracture |
| Zdroj: | BMC Musculoskeletal Disorders |
| ISSN: | 1471-2474 |
| Popis: | BACKGROUND: Most surgeons do not fix the lesser trochanter when managing femoral intertrochanteric fractures with intramedullary nails. We have not found any published clinical studies on the relationship between the integrity of the lesser trochanter and surgical outcomes of intertrochanteric fractures treated with intramedullary nails. The purpose of this study was to evaluate the impact of the integrity of the lesser trochanter on the surgical outcome of intertrochanteric fractures. METHODS: A retrospective review of 85 patients aged more than 60 years with femoral intertrochanteric fractures from January 2010 to July 2012 was performed. The patients were allocated to two groups: those with (n = 37) and without (n = 48) preoperative integrity of the lesser trochanter. Relevant patient variables and medical comorbidities were collected. Medical comorbidities were evaluated according to the American Society of Anesthesiologists classification and medical records were also reviewed for age, sex, time from injury to operation, intraoperative blood loss, volume of transfusion, operative time, length of stay, time to fracture union, Harris Hip Score 1 year postoperatively, and incidence of postoperative complications. Postoperative complications included deep infection (beneath the fascia lata), congestive heart failure, pulmonary embolus, cerebrovascular accident, pneumonia, cardiac arrhythmia, urinary tract infection, wound hematoma, pressure sores, delirium, and deep venous thrombosis. Variables were statistically compared between the two groups, with statistical significance at P 0.05). The group with preoperative integrity of the lesser trochanter had significantly less blood loss (107.03 ± 49.21 mL) than those without it (133.96 ± 58.08 mL) (P < 0.05) and the operative time was significantly shorter in the former (0.77 ± 0.07 hours) than the latter (0.84 ± 0.11 hours) group (P < 0.05). CONCLUSIONS: The integrity of the lesser trochanter has no significant influence on the surgical outcome of intramedullary nail internal fixation of femoral intertrochanteric fractures. |
| Databáze: | OpenAIRE |
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