Eugenio Jannelli1, Cristina Ghia2, Medetti Marta3, Gianluigi Pasta4, Alessandro Ivone4, Ester Boggio5, Gianluca Conza1, Fabio Zanchini1, Federico Alberto Grassi6, Mario Mosconi6. 1. Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli". 2. Orthopedic and Traumatology Clinic, Edoardo Agnelli Hospital. 3. Istituto clinico San Siro, IRCCS Istituto Ortopedico Galeazzi. 4. Orthopedic and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation. 5. Orthopedic and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia. 6. Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia.
Abstract
Background: IM nails are the gold standard of subtrochanteric fractures management. Indications to use a short rather than a long nail remain unclear. Operative complications of subtrochanteric fractures reach up to 25%. Objective: Retrospectively compare clinical and radiographic outcome of subtrochanteric fractures treated by long and short intramedullary nailing, analysing rates of complications. Methods: 390 patients were chosen from the archives. 194 patients were available: 70 treated with a short intramedullary nail (Group A), while 124 with long one (Group B). Radiographic evaluation at 6 and 12 months assess failure of the osteosynthesis. Clinical outcomes were the return to normal activities prior trauma and VAS scale. Group A mean age was 81.37 years, group B mean age was 78.9 years (29-99, SD: 15.38). Results: Radiografic Healing was found in 66 patients (94.28%) in group A, while in 116 patients (94.54%) in group B. Pseudarthrosis was found in 4 cases (5.71%) in group A, while in 8 cases (6.45%) in group B. Implant failure occurred in 5 cases: one required revision of fixation, while 4 require hip replacement. 59 patients of group A (84.29%) returned to social life, while 102 patients (81.94%) in group B. Group A mean VAS was 1.55, Group B mean VAS was 1.49. Conclusion: Comparison of the two group showed no differences. Complication percentages are in line with literature. Optimal reduction and fixation allow high percentage of healing and return to social life.
Background: IM nails are the gold standard of subtrochanteric fractures management. Indications to use a short rather than a long nail remain unclear. Operative complications of subtrochanteric fractures reach up to 25%. Objective: Retrospectively compare clinical and radiographic outcome of subtrochanteric fractures treated by long and short intramedullary nailing, analysing rates of complications. Methods: 390 patients were chosen from the archives. 194 patients were available: 70 treated with a short intramedullary nail (Group A), while 124 with long one (Group B). Radiographic evaluation at 6 and 12 months assess failure of the osteosynthesis. Clinical outcomes were the return to normal activities prior trauma and VAS scale. Group A mean age was 81.37 years, group B mean age was 78.9 years (29-99, SD: 15.38). Results: Radiografic Healing was found in 66 patients (94.28%) in group A, while in 116 patients (94.54%) in group B. Pseudarthrosis was found in 4 cases (5.71%) in group A, while in 8 cases (6.45%) in group B. Implant failure occurred in 5 cases: one required revision of fixation, while 4 require hip replacement. 59 patients of group A (84.29%) returned to social life, while 102 patients (81.94%) in group B. Group A mean VAS was 1.55, Group B mean VAS was 1.49. Conclusion: Comparison of the two group showed no differences. Complication percentages are in line with literature. Optimal reduction and fixation allow high percentage of healing and return to social life.
Entities:
Keywords:
Subtrochanteric femur fracture; bone healing; femur fracture; intramedullary nail
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