Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur

被引:123
作者
Aktselis, Ioannis [1 ]
Kokoroghiannis, Constantine [1 ]
Fragkomichalos, Evaggelos [1 ]
Koundis, Georgios [1 ]
Deligeorgis, Anastasios [1 ]
Daskalakis, Emmanouil [1 ]
Vlamis, John [2 ]
Papaioannou, Nikolaos [3 ]
机构
[1] KAT Gen Hosp, Orthopaed Dept E, Athens, Attica, Greece
[2] Univ Athens, KAT Gen Hosp, Orthopaed Dept 3, Athens, Attica, Greece
[3] Univ Athens, KAT Gen Hosp, Lab Res Musculoskeletal Syst Theodoros Garofalidi, Athens, Attica, Greece
关键词
AMBI sliding screw; AO/OTA 31 A2.2 and A2.3; Fractured neck of femur; Gamma nail; Intertrochanteric fractures; Intramedullary nail; Randomized trial; Sliding hip screw; PROXIMAL FEMORAL NAIL; GAMMA-NAIL; PERITROCHANTERIC FRACTURES; SUBTROCHANTERIC FRACTURES; FIXATION; PLATE; FAILURE; MANAGEMENT; WALL;
D O I
10.1007/s00264-013-2196-7
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
The purpose of this prospective randomised trial was to assess whether an intramedullary nail is superior to a sliding hip screw in the treatment of multifragmentary intertrochanteric fractures Eighty patients with a 31-A2.2 or A2.3 Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) intertrochanteric fracture were randomly allocated to fixation with either the Gamma nail or the AMBI sliding hip screw device. All patients were followed up at one, three, six and 12 months postoperatively, except for nine who died. There was no statistical difference in Parker mobility score between groups. The Gamma nail group had significantly higher Barthel Index and EuroQol-5D (EQ-5D) scores than the AMBI group at 12 months. At the same time, the EQ-5D score had returned to its pre-operative values in the Gamma nail group but not in the AMBI group. There were no differences in mortality, radiation time and hospital stay. Duration of the operation, incision length and hip pain occurrence were significantly less in the Gamma nail group. Few failures occur when unstable 31-A2.2 and A2.3 AO/OTA fractures are fixed with a sliding hip screw. Nevertheless, an intramedullary nail seems superior in reconstituting patients to their pre-operative state.
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收藏
页码:155 / 161
页数:7
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