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Treatment of Unstable Intertrochanteric Fractures : A Comparison of Proximal Femoral Nail and Dynamic Hip Screw

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Purpose: To retrospectively analyze and compare the results of proximal femoral nail (PFN) and dynamic hip screw (DHS) in the treatment of A22, 23 AO/OTA intertrochanteric fractures. Materials and methods: Out of 100 patients who had an A22,23 unstable intertrochantericfractures, 50 patients were treated with DHS (Group I) and 50 patients were treated with PFN (Group II). The age, gender, preoperative morbidity, intraoperative data (type of anesthesia, duration of surgery, the amount of blood transfusion, the position of implant) and postoperative functional status and complications of both groups were compared. Results: The mean surgical duration was shorter in the PFN group than in the DHS group (P=0.03) but the amount of transfusion was comparable. The intraoperative complications encountered were a femoral shaft fracture in the PFN group, cut-through of the lag screws in one patient from each group, and a loss of reduction in one hip in the DHS group. There were no significant differences in the union time, postoperative morbidity or mortality. The mobility score was higher in the PFN group than in the DHS group (P=0.02) even though the social function score was similar. Conclusion: The use of PFN has the advantage of a shorter operative time and a better mobility of patients without altering the overall course of patients’ recovery.

Abstract

Purpose: To retrospectively analyze and compare the results of proximal femoral nail (PFN) and dynamic hip screw (DHS) in the treatment of A22, 23 AO/OTA intertrochanteric fractures. Materials and methods: Out of 100 patients who had an A22,23 unstable intertrochantericfractures, 50 patients were treated with DHS (Group I) and 50 patients were treated with PFN (Group II). The age, gender, preoperative morbidity, intraoperative data (type of anesthesia, duration of surgery, the amount of blood transfusion, the position of implant) and postoperative functional status and complications of both groups were compared. Results: The mean surgical duration was shorter in the PFN group than in the DHS group (P=0.03) but the amount of transfusion was comparable. The intraoperative complications encountered were a femoral shaft fracture in the PFN group, cut-through of the lag screws in one patient from each group, and a loss of reduction in one hip in the DHS group. There were no significant differences in the union time, postoperative morbidity or mortality. The mobility score was higher in the PFN group than in the DHS group (P=0.02) even though the social function score was similar. Conclusion: The use of PFN has the advantage of a shorter operative time and a better mobility of patients without altering the overall course of patients’ recovery.

참고문헌 (30)

  1. "Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur", 15, pp.394~400 (2001)
  2. "The AO", ASIF proximal femoral nail (PFN) for the treatment of unstable trochanteric femoral fracture, 2002, pp.35(5), 395~399
  3. "Implant-related complications in the treatment of unstable intertrochanteric fractures: meta-analysis of dynamic screw-plate versus dynamic screw-intramedullary nail devices", 27, pp.197~203 (2003)
  4. "The treatment of unstable, extracapsular hip fractures with the AO", ASIF proximal femoral nail (PFN)--our first 60 cases, 2002, pp.33, 401~405
  5. "The proximal femoral nail (PFN)--a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months", 74(1), pp.53~58 (2003)
  6. "Cemented hemiarthroplasties for elderly patients with intertrochanteric fractures.", 371, pp.206~215 (2000)
  7. "Gamma nailing of pertrochanteric and subtrochanteric fractures, clinical results of a series of 63 consecutive cases", 11, pp.412~415 (1997)
  8. "Trochanteric fracture treated by the slidingscrew plate fixation method", pp.737~752 (1964)
  9. "mechanical failure after internal fixation", pp.72 26~31 (1990)
  10. "Unstable intertrochantericfractures of the hip", pp.49 440~450 (1967)
  11. "The treatment of trochanteric fractures of thefemur", pp.31~
  12. "Use of an intramedullary hip screw compared with a compression hip screw with a plate for intertrochanteric femoral fractures", 80-A, pp.618~630 (1998)
  13. "Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly", 33, pp.23~28 (2002)
  14. "An experimental study of the failure modes of the Gamma Locking Nail and AO Dynamic Hip Screw under static loading: a cadaveric study", 19, pp.446~453 (1997)
  15. MacEachern AG, "Treatment of intertrochanteric fractures of the femur Acomparison of the Richards screw-plate with the Jewettnail plate", pp.65 262~267 (1983)
  16. Jensen JS, "Determining factors for the morbilityfollowing hip fractures", pp.411~15 414 (1984)
  17. Klinger HM, "A comparative study of unstable per- and intertrochanteric femoral fractures treated with dynamic hip screw (DHS) and trochanteric butt-press plate vs.proximal femoral nail (PFN)", 130, pp.301~306 (2005)
  18. Koval KJ, "Weight bearing after hip fracture. A prospective series of 596 geriatric hip fracture patients", 10, pp.526~530 (1996)
  19. Koval KJ, "Intertrochanteric fractures. In: Bucholz RW, Heckman JD(eds). Fractures in Adults", pp.1635~1663 (2001), Philadelphia, Lippincott Williams and Wilkins
  20. Kyle RF, "Analysis of sixhundred and twenty-two intertrochanteric fractures", pp.61 216~221 (1976)
  21. Leung KS, "Gammanails and dynamic hip screws for peritrochantericfractures A randomized prospective study in elderlypatients", pp.74 345~351 (1992)
  22. Nuber S, "Stabilisation ofunstable trochanteric femoral fractures. Dynamic hip screw (DHS) with trochanteric stabilisation plate vs. proximal femur nail (PFN)", 106, pp.39~47 (2003)
  23. Parker MJ, "A new morbility score forpredicting mortality after hip fracture", pp.75 797~798 (1993)
  24. Rha JD, "Factors affecting sliding of the lag screw inintertrochanteric fractures", pp.320~324 (1993)
  25. Radford PJ, "A prospectiverandomized and comparison of the dynamic hip screw andGamma locking nail", pp.75 789~793 (1993)
  26. Rosenblum S F, "A biomechanical evaluation of the Gamma nail", pp.74 352~357 (1992)
  27. Sadowski C, "Treatment of reverse obliquity and transverse intertrochanteric fractures with use of an intramedullary nail of a 95o screwplate", 84-A, pp.372~382 (2002)
  28. Saudan M, "Pertrochanteric fractures: is there an advantage to an intramedullary nail?: A randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail", 16, pp.386~393 (2002)
  29. Simmermacher RKJ, "The AO", ASIF proximal femoral nail (PFN) a new device for the treatment of unstable proximal femoral fractures, 1999, pp.30, 327~332
  30. Wolfgang GL, "Treatment ofintertrochanteric fractures of the femur using slidingscrew plate fixation 44 임 군 일Treatment of Unstable Intertrochanteric Fractures A Comparison of Proximal Femoral Nail and Dynamic Hip ScrewGun Il Im", pp.148~158 (1982)

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