Application of simple scoring method in prognosis of intramedullary fixation for elderly femoral intertrochanteric fractures
Objective To establish simple quantitative scoring(SQS)method by the overall stability of internal fixation and fracture end after intramedullary fixation of intertrochanteric femur fracture(ITF)in the elderly,to study the relationship between SQS and internal fixation failure and Harris score of the hip,and to explore the clinical value of SQS on the prognosis of intramedullary surgery of ITF in the elderly.Methods A retro-spective study was conducted to analyze 347 cases of ITF patients with inclusion criteria from January 2020 to December 2022 in our hospital.The SQS was designed by 10 parameters such as postoperative X-ray bone quality,medial repositioning,lateral wall,and intramedullary nail fixation point,and the consistency of three physicians'SQS scores was analyzed using Kappa.The SQS was analyzed and the sensitivity and specificity of the AO score for internal fixation failure were compared using the subject's work characteristics(ROC)curve.Correlations between SQS scores and internal fixation failure and Harris scores were assessed.Results 347 patients were followed up for 6 months-2.5 years with a mean of 11.3 months,with an internal fixation failure rate of 12.1%(42/347),and an excellent Harris rate of 66.0%(229/347).In this study SQS was 4-10 and ROC showed area under the curve AUC=83.6%,Fleiss Kappa suggested high consistency of SQS score.Univariate analysis suggested that internal fixation failure was associated with SQS(P<0.001).Further study categorized the scores into three groups of 6,7,and 8-10,and χ2 test showed statistically significant differences in internal fixation failure rates and differences in hip Harris scores among the three SQS groups were moderately correlated.Conclusion The SQS is accurate and effective in predicting internal fixation failure and hip function after intramedullary fixation of ITF in the elderly,and has good application value.
Simple quantitative scoringmethodIntertrochanteric femur fractureInternal fixation failureHip function
万方数据
维普
