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Clinical and Radiologic Outcomes among Bipolar Hemiarthroplasty, Compression Hip Screw and Proximal Femur Nail Antirotation in Treating Comminuted Intertrochanteric Fractures

박종석|최형석|김성민|노재휘|서유성|홍시전
대한고관절학회 (The Korean Hip Society)|2015.03|Hip and Pelvis|제27권 제1호|pp. 30-35|DOI 10.5371/hp.2015.27.1.30

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키워드

Intertrochanteric fractureCompression hip screwBipolar hemiarthroplastyProximal femur nail antirotation

초록

Purpose: In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23])Materials and Methods: We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). Results: There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). Conclusion: There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH<PFNA<CHS).

Abstract

Purpose: In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23])Materials and Methods: We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). Results: There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). Conclusion: There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH<PFNA<CHS).

참고문헌 (26)

  1. Carpentier K, "Internal fixation of an intertrochanteric femoral fracture after Birmingham hip resurfacing arthroplasty", Acta Orthop Belg, 78, pp.275~278 (2012)
  2. Anglen JO, "Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database", J Bone Joint Surg Am, 90, pp.700~707 (2008)
  3. Kreder HJ, "TRIGEN INTERTAN intramedullary nail versus sliding hip screw. A prospective, randomized multicenter study on pain, function, and complications in 684 patients with an intertrochanteric or subtrochanteric fracture and one year of follow-up", J Bone Joint Surg Am, 95, pp.e16(1)~e16(2) (2013)
  4. Matre K, "TRIGEN INTERTAN intramedullary nail versus sliding hip screw : a prospective, randomized multicenter study on pain, function, and complications in 684 patients with an intertrochanteric or subtrochanteric fracture and one year of follow-up", J Bone Joint Surg Am, 95, pp.200~208 (2013)
  5. Swart E, "Cost-effectiveness analysis of fixation options for intertrochanteric hip fractures", J Bone Joint Surg Am, 96, pp.1612~1620 (2014)
  6. 이영균, "National Trends of Surgical Treatment for Intertrochanteric Fractures in Korea", Journal of Korean Medical Science, 28(9), pp.1407~1408 (2013), 대한의학회
  7. Guo Q, "Percutaneous compression plate versus proximal femoral nail anti-rotation in treating elderly patients with intertrochanteric fractures : a prospective randomized study", J Orthop Sci, 18, pp.977~986 (2013)
  8. Shen J, "Bipolar hemiarthroplasty compared with internal fixation for unstable intertrochanteric fractures in elderly patients", J Orthop Sci, 17, pp.722~729 (2012)
  9. Parker MJ, "Sliding hip screw versus the Targon PF nail in the treatment of trochanteric fractures of the hip : a randomised trial of 600 fractures", J Bone Joint Surg Br, 94, pp.391~397 (2012)
  10. Chen YT, "Diaphyseal locking hip arthroplasty for treatment of failed fixation of intertrochanteric hip fractures", J Arthroplasty, 23, pp.241~246 (2008)
  11. Lee YK, "Cementless bipolar hemiarthroplasty using a hydroxyapatite -coated long stem for osteoporotic unstable intertrochanteric fractures", J Arthroplasty, 26, pp.626~632 (2011)
  12. Won Sik Choy, "Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients", Clinics in Orthopedic Surgery, 2(4), pp.221~226 (2010), 대한정형외과학회
  13. Maxwell C, "Sensitivity and accuracy of the visual analogue scale : a psycho-physical classroom experiment", Br J Clin Pharmacol, 6, pp.15~24 (1978)
  14. Koval KJ, "Functional recovery after fracture of the hip", J Bone Joint Surg Am, 76, pp.751~758 (1994)
  15. Koval KJ, "Functional outcome after hip fracture. Effect of general versus regional anesthesia", Clin Orthop Relat Res, 348, pp.37~41 (1998)
  16. Nho JH, "Reliability and validity of measuring version of the acetabular component", J Bone Joint Surg Br, 94, pp.32~36 (2012)
  17. Egol KA, "Can the use of an evidence-based algorithm for the treatment of intertrochanteric fractures of the hip maintain quality at a reduced cost?", Bone Joint J, 96(B), pp.1192~1197 (2014)
  18. Baumgaertner MR, "The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip", J Bone Joint Surg Am, 77, pp.1058~1064 (1995)
  19. Kazemian GH, "Treatment of intertrochanteric fractures in elderly highrisk patients:dynamic hip screw vs. external fixation", Injury, 45, pp.568~572 (2014)
  20. Lee YK, "Intramedullary nail versus extramedullary plate fixation for unstable intertrochanteric fractures : decision analysis", Arch Orthop Trauma Surg, 133, pp.961~968 (2013)
  21. Cole PA, "What’s new in orthopaedic trauma", J Bone Joint Surg Am, 88, pp.2545~2561 (2006)
  22. Shen L, "Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures : a meta-analysis of randomized controlled studies", Orthop Traumatol Surg Res, 99, pp.377~383 (2013)
  23. Chang Q, "Bipolar hip arthroplasty", J Arthroplasty, 26, pp.1455~1459 (2011)
  24. Chan KC, "Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures", Clin Orthop Relat Res, 371, pp.206~215 (2000)
  25. Kaufer H, "Mechanics of the treatment of hip injuries", Clin Orthop Relat Res, 146, pp.53~61 (1980)
  26. Harrington P, "Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly", Injury, 33, pp.23~28 (2002)

관련 논문AI추천

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