Takigawa Naohide, Moriuchi Hiromitsu, Abe Muneki, Yasui Kenji, Eshiro Hisako, Kinoshita Mitsuo
Department of Orthopaedic Surgery, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan.
Department of Orthopaedic Surgery, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan.
Injury. 2014 Jan;45 Suppl 1:S44-8. doi: 10.1016/j.injury.2013.10.036. Epub 2013 Nov 1.
The purpose of this study was to analyse clinical results of elderly patients with trochanteric fractures that were treated with use of TARGON(®) PF nail. Overall, 494 patients (113 males) were available for this study. On the basis of Jensen classification, there were 76 cases in type I, 164 cases in type II, 70 in type III, 129 in type IV and 55 in type V. (1) Sliding amount of lag screw in relation to the Jensen classification, (2) sliding amount of lag screw according to the Ikuta's classification that categorises the reduction in lateral view in three, Subtype A, Subtype N and Subtype P, (3) sliding amount of lag screw in correlation between Jensen classification and Ikuta's classification and (4) postoperative complications (9 cases; 1.7%) were assessed. Cut-out and back-out cases were seen in 6 cases (1.1%), and these severe complications were evaluated in details. In correlation between Jensen classification and Ikuta's classification, the excessive sliding of lag screw was prominent with the Subtype P, which was preoperatively in Jensen type III or V. Cut-out or back-out cases were caused either from (1) Subtype P that were preoperatively Jensen types III or V, or from (2) the fracture where there was bony defect anteriorly. Therefore, special care must be taken for these types.
本研究的目的是分析使用TARGON(®) PF髓内钉治疗老年转子间骨折的临床结果。总体而言,本研究纳入了494例患者(113例男性)。根据Jensen分型,I型76例,II型164例,III型70例,IV型129例,V型55例。评估了(1)拉力螺钉滑动量与Jensen分型的关系,(2)根据Ikuta分型(将侧位复位分为A亚型、N亚型和P亚型)的拉力螺钉滑动量,(3)Jensen分型与Ikuta分型相关性中的拉力螺钉滑动量,以及(4)术后并发症(9例;1.7%)。观察到6例(1.1%)出现切割和退出病例,并对这些严重并发症进行了详细评估。在Jensen分型与Ikuta分型的相关性中,术前为Jensen III型或V型的P亚型拉力螺钉过度滑动明显。切割或退出病例要么由(1)术前为Jensen III型或V型的P亚型引起,要么由(2)前方存在骨缺损的骨折引起。因此,对于这些类型必须特别小心。