Lei Zhang1, Jie Shen2, Sixu Chen3, Zhendong Wu3, Zaiyu Huang3, Shuai He4, Zhihao Ying3, Dan Liu3, Yong Wang5. 1. Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China. Electronic address: zhanglei_1121@126.com. 2. National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. 3. Department of Orthopaedics, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China. 4. Department of Stomatology, The 118th PLA Hospital, Wenzhou, Zhejiang, 325000, China. 5. Department of Orthopaedics, Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou, Wenzhou, Zhejiang, 325000, China. Electronic address: wyhpi008@163.com.
Abstract
INTRODUCTION: Intertrochanteric femoral fractures remain a challenge to orthopedists. Although technologies and instruments have been continuously improved, fixation failure still poses a problem in the treatment of unstable intertrochanteric femoral fractures. The objective of the present study was to evaluate the clinical efficacy of a new type of intramedullary fixing device--locking gamma nail (LGN)--in treating unstable intertrochanteric femoral fractures. METHODS: From March 2009 to March 2012, 88 patients with unstable intertrochanteric femoral fractures were treated at our department with LGNs. Twelve patients were excluded from the study. The clinical and radiographic results of the remaining 76 patients were retrospectively analyzed. RESULTS: The mean duration of operation, volume of blood loss, and hospital stay was 50 min, 85 mL, and 8.5 days, respectively. No perioperative complications. Seven patients died 1 year after surgery. The other 69 patients received a mean 23-month follow-up. The mean fracture healing time was 16 weeks. Nine patients felt pain in their hips. Ten patients experienced delayed fracture healing. No other complications. Sixty-one patients had recovered to preoperative levels of function, with a mean Harris hip score of 86.6 and a mean Parker-Palmer mobility score of 7.42. Patients with malreduction were more likely to sustain pain complications (p = 0.002). Older patients were more likely to experience delayed fracture healing (p = 0.045). CONCLUSIONS: LGN is a simple and safe treatment for unstable intertrochanteric femoral fractures with satisfactory clinical efficacy and may be considered a new, minimally invasive operative method for treating unstable intertrochanteric femoral fractures.
INTRODUCTION: Intertrochanteric femoral fractures remain a challenge to orthopedists. Although technologies and instruments have been continuously improved, fixation failure still poses a problem in the treatment of unstable intertrochanteric femoral fractures. The objective of the present study was to evaluate the clinical efficacy of a new type of intramedullary fixing device--locking gamma nail (LGN)--in treating unstable intertrochanteric femoral fractures. METHODS: From March 2009 to March 2012, 88 patients with unstable intertrochanteric femoral fractures were treated at our department with LGNs. Twelve patients were excluded from the study. The clinical and radiographic results of the remaining 76 patients were retrospectively analyzed. RESULTS: The mean duration of operation, volume of blood loss, and hospital stay was 50 min, 85 mL, and 8.5 days, respectively. No perioperative complications. Seven patients died 1 year after surgery. The other 69 patients received a mean 23-month follow-up. The mean fracture healing time was 16 weeks. Nine patients felt pain in their hips. Ten patients experienced delayed fracture healing. No other complications. Sixty-one patients had recovered to preoperative levels of function, with a mean Harris hip score of 86.6 and a mean Parker-Palmer mobility score of 7.42. Patients with malreduction were more likely to sustain pain complications (p = 0.002). Older patients were more likely to experience delayed fracture healing (p = 0.045). CONCLUSIONS: LGN is a simple and safe treatment for unstable intertrochanteric femoral fractures with satisfactory clinical efficacy and may be considered a new, minimally invasive operative method for treating unstable intertrochanteric femoral fractures.