دورية أكاديمية
Nailing unstable pertrochanteric fractures: does size matters?
| العنوان: | Nailing unstable pertrochanteric fractures: does size matters? |
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| المؤلفون: | Luque Pérez R; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain. doctorluque@yahoo.es., Checa Betegón P; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain., Galán-Olleros M; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain., Arvinius C; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain., Valle-Cruz J; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain., Marco F; Orthopaedic Surgery and Traumatology Department, Clínico San Carlos Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos s/n, 28004, Madrid, Spain.; Surgery Department, Complutense University, Madrid, Spain. |
| المصدر: | Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2022 Jan; Vol. 142 (1), pp. 145-155. Date of Electronic Publication: 2020 Nov 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9011043 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-3916 (Electronic) Linking ISSN: 09368051 NLM ISO Abbreviation: Arch Orthop Trauma Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Berlin : Springer Verlag Original Publication: Berlin : Springer International, c1989- |
| مواضيع طبية MeSH: | Femoral Fractures* , Fracture Fixation, Intramedullary*/adverse effects , Hip Fractures*/surgery, Aged ; Aged, 80 and over ; Bone Nails ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Introduction and Objectives: New generation cephalomedullary nails are, currently, widely used for the treatment of trochanteric proximal femoral fractures. This study aims to compare the midterm outcomes and complication rates in patients with unstable 31A2 fractures treated with two different lengths of nails. Materials and Methods: Retrospective study including 123 pertrochanteric proximal femoral fractures 31A2 treated with Gamma3 nail ® between January/2017 and January/2019. 19 patients were excluded, resulting in a total of 104 patients with a minimum follow-up of 1 year. Two groups, Long Dynamic Gamma3 Nail (LGN) and Short Static Gamma3 Nail (SGN), with 52 patients each were compared. Mean age was 81 years (range 50-99), being 78% female. Preoperative variables included: age, medical comorbidities, mobility, anesthetic risk, associated fractures, hemoglobin and hematocrit values. Postoperatively, functional and radiological results, quality of life, hemoglobin and hematocrit concentration, transfusion requirements, mobility, and pain were evaluated. Additionally, perioperative complications were also analyzed, such as malunion, non-union, infection rates, cut-outs, and peri-implant fractures. Results: A correct radiological fracture reduction was obtained in 73% of the cases (73% SGN/74% LGN). Two patients in LGN group had intraoperative complications (greater trochanter fractures). 38% of the patients with LGN presented nail tip impaction upon the distal anterior femoral cortex, associated with anterior knee pain. Blood loss and operative time was statistically different between groups. Despite the previous, no differences in clinical outcomes and quality of life were found. Conclusions: The present study comparing two lengths of the Gamma3 Nail in 31A2 fractures showed no overall differences in clinical and radiological outcomes, and complication rates. However, the use of LGN was associated with a statistically significant higher blood loss and operative time, and a tendency for increased need for transfusion, and anterior knee pain and reoperation rate. Therefore, we recommend the use of locked SGN in the treatment of 31A2 fractures. (© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Comparative study; Fracture fixation; Hip fractures; Intramedullary; Intramedullary nailing; Trochanteric fractures |
| تواريخ الأحداث: | Date Created: 20201104 Date Completed: 20220107 Latest Revision: 20220107 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1007/s00402-020-03668-0 |
| PMID: | 33146752 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1434-3916 |
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| DOI: | 10.1007/s00402-020-03668-0 |