Dergiler / Ulusal Travma ve Acil Cerrahi Dergisi / 2018 / Cilt: 24 - Sayı: 2

Fixation of rotationally unstable extracapsular proximal femoral fractures

Sayfa
168–174
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Insignificant differences between outcomes of IGU and PGU render the addition of the AO types A1.2 and A1.3 to the rotationally unstable fractures reasonable

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:BACKGROUND: It was thought that the AO types A1.2 and A1.3 fractures are rotationally stable; however, it revealed instability when fixed using the dynamic hip screw.
📊
Temel Bulgular & Veri:METHODS: A series of 83 fractures of the AO types A1, A2, and B2.1 were treated using dynamic hip screw with derotation screw (DHS/DRS) composite and then prospectively followed for 24 months.
💡
Sonuç & Katkı:Insignificant differences between outcomes of IGU and PGU render the addition of the AO types A1.2 and A1.3 to the rotationally unstable fractures reasonable
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Abstract

BACKGROUND: It was thought that the AO types A1.2 and A1.3 fractures are rotationally stable; however, it revealed instability when fixed using the dynamic hip screw. Therefore, we hypothesized that these fractures should be treated as rotationally unstable. METHODS: A series of 83 fractures of the AO types A1, A2, and B2.1 were treated using dynamic hip screw with derotation screw (DHS/DRS) composite and then prospectively followed for 24 months. Adequacy of reduction and fixation were immediately assessed after surgery, and fracture collapse was assessed at six months or when fractures healed. To investigate the feasibility of our hypothesis, fractures were classified into two groups: 1) the inevitably unstable group (IUG) included the AO types A1.1, A2.1, A2.2, A2.3, and B2.1 fractures and 2) the potentially unstable group (PUG) included the AO types A1.2 and A1.3 fractures. The results were statistically analyzed.RESULTS: Adequate reduction was achieved in 77 and adequate fixation in 71 fractures. All fractures healed in a mean time of 13.5 weeks, and the amount of the fracture collapse averaged 5.8 mm. Equalization of the lower limbs was achieved in 66 patients, and hip motion range equalized the healthy contralateral in 80 patients. Re-operation was performed in one case with AO type A1.2. Comparison of IUG and PUG using the outcomes revealed insignificant differences.CONCLUSION: Using the DHS/DRS composite, anatomical features of the proximal femoral end were restored and maintained during the follow-up period. Insignificant differences between outcomes of IGU and PGU render the addition of the AO types A1.2 and A1.3 to the rotationally unstable fractures reasonable

🔖

Bu Makaleye Atıf Yap

MASSOUD, E. I. E. (2018). Fixation of rotationally unstable extracapsular proximal femoral fractures. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 24 - Sayı: 2, 168–174. https://ajindex.com/articles/324698

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (14)

  1. Oliver D, Griffiths R, Roche J, Sahota O. Hip fracture. BMJ Clin Evid 2007. pii: 1110
  2. Mittal R, Banerjee S. Proximal femoral fractures: Principles of management and review of literature. J Clin Orthop Trauma 2012;3:15–23
  3. Massoud EI. Fixation of basicervical and related fractures. Int Orthop 2010;34:577–82
  4. Jensen JS. Classification of trochanteric fractures. Acta Orthop Scand 1980;51:803–10
  5. Aguado-Maestro I, Escudero-Marcos R, García-García JM, Alonso-García N, Pérez-Bermejo D D, Aguado-Hernández HJ, et al. Results and complications of pertrochanteric hip fractures using an intramedullary nail with a helical blade (proximal femoral nail antirotation) in 200 patients. Rev Esp Cir Ortop Traumatol 2013;57:201–7
  6. Deneka DA, Simonian PT, Stankewich CJ, Eckert D, Chapman JR, Tencer AF. Biomechanical comparison of internal fixation techniques for the treatment of unstable basicervical femoral neck fractures. J Orthop Trauma 1997;11:337–43
  7. Baitner AC, Maurer SG, Hickey DG, Jazrawi LM, Kummer FJ, Jamal J, et al. Vertical shear fractures of the femoral neck. A biomechanical study. Clin Orthop Relat Res 1999:300–5
  8. Pajarinen J, Lindahl J, Michelsson O, Savolainen V, Hirvensalo E. Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation. J Bone Joint Surg Br 2005;87:76–81
  9. Foulongne E, Gilleron M, Roussignol X, Lenoble E, Dujardin F. Miniinvasive nail versus DHS to fix pertrochanteric fractures: a case-control study. Orthop Traumatol Surg Res 2009;95:592–8
  10. Watson ST, Schaller TM, Tanner SL, Adams JD, Jeray KJ. Outcomes of Low-Energy Basicervical Proximal Femoral Fractures Treated with Cephalomedullary Fixation. J Bone Joint Surg Am 2016;98:1097–102
  11. Xu YZ, Geng DC, Mao HQ, Zhu XS, Yang HL. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res 2010;38:1266–75
  12. Takano MI, de Moraes RC, de Almeida LG, Queiroz RD. Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures. Rev Bras Ortop 2014;49:17–24
  13. Müller ME, Allgöwer M, Schneider R, Willenegger H, editors. Proximal femur. In: Manual of internal fixation: techniques recommended by the AO-ASIF Group. 3rd ed. Berlin: Springer; 1992. p. 522–30
  14. Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two intertrochanteric hip fract