Treatment outcomes of proximal femoral compression intramedullary nailing combined with wire binding for intertrochanteric fractures with unstable lateral wall
Objective To explore the surgical method of proximal femoral compression intramedullary nail-ing combined with wire binding in the treatment of intertrochanteric fractures with unstable femoral lateral wall and the postoperative effects.Methods A retrospective analysis was performed on19 patients of intertrochanteric frac-tures with unstable femoral lateral walls in the Department of Bone and Joint Surgery,Hanzhong Central Hospital be-tween Mar.2020 and Mar.2022.There were 8 males and 11 females aged 56-82 (mean 73.1) years,with 17 cases of falls and 2 road traffic injuries.According to the new criteria of AO/OTA fracture classifications in 2018,the un-stable femoral lateral wall was defined as those ≥A2 types.In this study,there were 4 cases of type A2.2,8 type A2.3,2 type A3.1,1 type A3.2 and 4 type A3.3.Before surgery,all patients underwent normal position radio-graphy of bilateral hips and lateral radiography of the affected hip,or hip CT plain and 3D reconstruction if necessa-ry.All patients were managed by proximal femoral compression intramedullary nailing combined with wire binding.The hospitalization time,operation time,blood bleeding,and postoperative off-bed activity time were recorded.At 3 months after surgery,the hip functional score,fracture reduction and healing,and postoperative complications were analyzed.Results Patients were followed up for 6-12 (mean 9.5) months.For all the cases,the hospitalization time was 10-23 (mean 15.4) d,operation time 0.75-2 (mean 1.2) h,blood loss 100-220 (mean 160.7) mL,off-bed activity time 7-14 (mean 9.8) d.Fracture healing was achieved in 3-6 (mean 4.1) months and no nonunion was found.Postoperative X-ray showed 12 cases of good reduction,5 fair and 2 poor.The Harris hip functional score was 68-97 (mean 85.4) at 3 months after surgery,with 12 excellent,4 good,2 fair and 1 poor.The excellent-to-good rate was 84.2％.Conclusion The treatment outcomes of proximal femoral compression intramedullary nailing combined with small-incision wire binding are satisfactory for unstable lateral wall intertrochanteric fractures.
万方数据
维普
