Bjørgul Kristian, Reikerås Olav
Department of Orthopaedics, Østfold Hospital, Oslo, Norway.
Acta Orthop. 2007 Apr;78(2):231-5. doi: 10.1080/17453670710013735.
A high reoperation rate has been the main reason why Gamma nailing should not be recommended for routine use in the treatment of trochanteric fractures. We compared the outcome after reoperation to the outcome after primary surgery with Gamma nailing.
In a series of 554 patients, we compared the outcome in 52 patients who were reoperated with that in 502 patients who had no reoperations. We assessed mortality, pain, walking ability and habitat at follow-up.
The most common reason for reoperation was new fracture around the implant (17), local pain after healed fracture (11), nonunion (9) and cut-out (8). A second reoperation was required in 9/52 patients. The mortality was significantly lower in the reoperated cases at 30 days and at 1-5 years, but not at 120 days, and there were no significant differences in the other outcome parameters.
Reoperation did not lead to a worse clinical outcome, nor to increased mortality.
高再手术率一直是不推荐将Gamma钉常规用于治疗转子间骨折的主要原因。我们比较了再手术后的结果与初次使用Gamma钉手术的结果。
在一系列554例患者中，我们比较了52例接受再手术患者与502例未接受再手术患者的结果。我们在随访时评估了死亡率、疼痛、行走能力和生活状况。
再手术最常见的原因是植入物周围新骨折（17例）、骨折愈合后局部疼痛（11例）、骨不连（9例）和穿出（8例）。9/52例患者需要二次再手术。再手术患者在30天和1至5年时的死亡率显著较低，但在120天时并非如此，其他结果参数无显著差异。
再手术并未导致更差的临床结果，也未增加死亡率。
