An overview of patients with intertrochanteric femoral fractures treated with proximal femoral nail fixation using important criteria

被引：0
作者：
Aygun, Umit [1 ]
Senocak, Eyup [2 ]
Aksay, Mehmet Fatih [1 ]
Cicek, Ali Can [1 ]
Halac, Orkun [3 ]
Toy, Serdar [4 ,5 ]
机构：
[1] Agri Ibrahim Cecen Univ, Fac Med, Dept Orthopaed & Traumatol, Agri, Turkiye
[2] Ataturk Univ, Fac Med, Dept Orthopaed & Traumatol, Erzurum, Turkiye
[3] Agri Training & Res Hosp, Orthoped & Traumatol Clin, Agri, Turkiye
[4] Basaksehir Cam & Sakura City Hosp, Dept Orthopaed, Istanbul, Turkiye
[5] Basaksehir Cam & Sakura City Hosp, Traumatol Clin, Istanbul, Turkiye
来源：
BMC MUSCULOSKELETAL DISORDERS | 2024年 / 25卷 / 01期
关键词：
Intertrochanteric femoral fracture; Tip-apex distance; Postoperative reduction classification; Cleveland zone; Radiographic union scale for the hip; Functional scores; SLIDING HIP SCREW; TIP-APEX DISTANCE; TROCHANTERIC FRACTURES; ELDERLY-PATIENTS; TERM; MORTALITY; OUTCOMES; FAILURE; PFNA; LIFE;
D O I：
10.1186/s12891-024-08197-0
中图分类号：
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Background This study aimed to assess important criteria, including osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union, in patients with intertrochanteric femoral fractures treated with proximal femoral nail (PFN) fixation and to show their effect on clinical outcomes. Methods PFN fixation was applied in 73 patients (41 females, 32 males; mean age: 64.5 +/- 6.2). The T score, fracture type according to the AO Foundation and Orthopedic Trauma Association (AO/OTA), implant-related complications (IRCs), Harris hip score (HHS), Jensen social function (JSF) score, and Parker-Palmer mobility score (PPMS), postoperative reduction classification, screw position according to the Cleveland zone, Radiographic Union Scale for the Hip (RUSH) score, and tip-apex distance (TAD) were recorded. Results Most screws were in central-central (n = 42) and inferior-central (n = 11) positions. IRCs were seen mostly in cases of screws placed in peripheral zones (n = 10) and were not observed in almost any patient with a TAD <= 25 mm (n = 52) (p < 0.001). Most of the patients with acceptable or good fracture reduction did not have IRCs (n = 11 and 50, respectively) (p < 0.001). Half of type 3A1 (n = 13) and most type 3A2 (n = 20) fractures showed radiographic union at 3 months, and most type 3A3 (n = 9) fractures showed radiographic union at 5 months (p < 0.05). At 12 months, type 3A2 fractures had the highest HHS (79.2 +/- 5.3) and PPMS (3.9 +/- 1.5), while type 3A3 fractures had the lowest HHS (70.3 +/- 4.6) and PPMS (0.6 +/- 2.8) (p < 0.05). At 12 and 24 months, type 3A3 fractures had higher JSF scores (2.8 +/- 0.4 and 3.5 +/- 0.5, respectively); at 3 months, type 3A1 fractures had higher JSF scores (3.1 +/- 0.3) (p < 0.05). The radiographic bone union time was prolonged in patients with a T score <= -2.5 standard deviation (SD) (p < 0.05). The HHS and PPMS increased while the RUSH score, considered as the radiographic union, was going towards the 4th month and decreased after the 4th month (p < 0.05). Conclusions Considering the criteria (osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union) examined in this study, satisfactory results can be obtained with PFN fixation in the treatment of patients with intertrochanteric femoral fractures.
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