Zhanle Zheng1, Huan Liu1, Xian Yu2, Sheng Li1, Yingze Zhang3. 1. Department of Trauma Emergency Center, Key Laboratory of Orthopaedics, the Third Hospital of Hebei Medical University, Shijiazhuang Hebei, 050051, P.R.China. 2. Department of Endocrinology, Hebei General Hospital, Shijiazhuang Hebei, 050051, P.R.China. 3. Department of Trauma Emergency Center, Key Laboratory of Orthopaedics, the Third Hospital of Hebei Medical University, Shijiazhuang Hebei, 050051, P.R.China.yzling_liu@163.com.
Abstract
OBJECTIVE: To evaluate the effectiveness of the leverage reduction with proximal femoral nail antirotation (PFNA) ball head screw driver for difficult-reducing intertrochanteric fracture. METHODS: The clinical data of 8 patients with difficult-reducing intertrochanteric fractures between July 2015 and February 2018 were retrospectively analysed. There were 3 males and 5 females, aged 66-89 years, with an average age of 76.3 years. According to Evans classification, there were 3 cases of type Ⅲ and 5 cases of type Ⅳ. The time from injury to operation was 2-8 days (mean, 3.9 days). All patients were reducted with ball head screw driver leverage through PFNA proximal incision during operation. The operation time, intraoperative blood loss, reduction time, and fluoroscopy times were recorded. Harris hip function score was used to evaluate the effectiveness at last follow-up. RESULTS: The operation time was 52.5-83.7 minutes (mean, 68.1 minutes), the intraoperative blood loss was 49.8-96.4 mL (mean, 73.1 mL), the reduction time was 3.7-9.1 minutes (mean, 6.4 minutes), and the fluoroscopy times were 18.4-27.4 times (mean, 22.9 times). Patients were followed up 6-18 months (mean, 9.6 months). Postoperative X-ray films showed that the fracture obtained good reduction. No fracture displacement, fixation failure, and coxa vara occurred after operation. Fracture healing time was 3-6 months (mean, 4.6 months). At last follow-up, the Harris hip function score was 85-96 (mean, 91.6), with a result of excellent in 6 cases and good in 2 cases. CONCLUSION: The reduction of difficult-reducing intertrochanteric fracture by using ball head screw driver can obtain good reduction and reliable fixation. The method has such advantages as no more incision, and less blood loss and soft tissue injury.
OBJECTIVE: To evaluate the effectiveness of the leverage reduction with proximal femoral nail antirotation (PFNA) ball head screw driver for difficult-reducing intertrochanteric fracture. METHODS: The clinical data of 8 patients with difficult-reducing intertrochanteric fractures between July 2015 and February 2018 were retrospectively analysed. There were 3 males and 5 females, aged 66-89 years, with an average age of 76.3 years. According to Evans classification, there were 3 cases of type Ⅲ and 5 cases of type Ⅳ. The time from injury to operation was 2-8 days (mean, 3.9 days). All patients were reducted with ball head screw driver leverage through PFNA proximal incision during operation. The operation time, intraoperative blood loss, reduction time, and fluoroscopy times were recorded. Harris hip function score was used to evaluate the effectiveness at last follow-up. RESULTS: The operation time was 52.5-83.7 minutes (mean, 68.1 minutes), the intraoperative blood loss was 49.8-96.4 mL (mean, 73.1 mL), the reduction time was 3.7-9.1 minutes (mean, 6.4 minutes), and the fluoroscopy times were 18.4-27.4 times (mean, 22.9 times). Patients were followed up 6-18 months (mean, 9.6 months). Postoperative X-ray films showed that the fracture obtained good reduction. No fracture displacement, fixation failure, and coxa vara occurred after operation. Fracture healing time was 3-6 months (mean, 4.6 months). At last follow-up, the Harris hip function score was 85-96 (mean, 91.6), with a result of excellent in 6 cases and good in 2 cases. CONCLUSION: The reduction of difficult-reducing intertrochanteric fracture by using ball head screw driver can obtain good reduction and reliable fixation. The method has such advantages as no more incision, and less blood loss and soft tissue injury.
Entities:
Keywords:
Intertrochanteric fracture; internal fixation; proximal femoral nail antirotation; reduction