Seo Jae-Seong, Min Hak-Jin, Kim Dong Min, Oh Seung-Min, Kim Sang-Min
Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.
Hip Pelvis. 2016 Dec;28(4):225-231. doi: 10.5371/hp.2016.28.4.225. Epub 2016 Dec 28.
Cephalomedullary nail (CM nail) in the treatment of femoral intertrochanteric fractures is in the lime light in recent years. The purpose of this study is to compare surgical outcomes between experienced surgeon and non-experienced surgeons in respect of CM nail for femoral intertrochanteric fractures.
The 129 patients underwent CM nail for femoral intertrochanteric fracture more than six months of follow-up from April 2011 to March 2014 in Seoul Medical Center (Seoul, Korea) were participated in this study. For this study, group A consisted of experienced surgeons who performed more than 500 times of CM nail, and group B consisted of non-experienced surgeons who performed less than 50 times of CM nail. Clinical and radiologic outcomes, complications and the need for reoperation between both groups were compared in the study.
According to clinical result, both the mean operation time and transfusion volume were significantly longer and greater in group B (<0.05). In the radiologic outcomes, adequacy of reduction, tip-apex distance and numbers of case placed in the Cleveland zones 5, 6 and 8; there was no statistical difference between both groups. Moreover, rate of complication and reoperation had same results as radiologic outcomes.
There was no significant difference with statistical data in complications from CM nail for femoral intertrochanteric fractures between experienced surgeon and non-experienced surgeon. Although the operation time and transfusion volume were significantly longer and greater in the case of operation by non-experienced surgeon, satisfactory performance was seen in the complications and the need for reoperation.
近年来,髓内钉治疗股骨粗隆间骨折备受关注。本研究旨在比较经验丰富的外科医生和经验不足的外科医生使用髓内钉治疗股骨粗隆间骨折的手术效果。
选取2011年4月至2014年3月在首尔医疗中心(韩国首尔)接受髓内钉治疗股骨粗隆间骨折且随访超过6个月的129例患者参与本研究。本研究中,A组由进行过500次以上髓内钉手术的经验丰富的外科医生组成,B组由进行过少于50次髓内钉手术的经验不足的外科医生组成。比较两组的临床和影像学结果、并发症及再次手术的必要性。
根据临床结果,B组的平均手术时间和输血量均显著更长、更多(<0.05)。在影像学结果方面,复位的充分性、尖顶距以及位于克利夫兰分区5、6和8区的病例数;两组之间无统计学差异。此外,并发症发生率和再次手术率与影像学结果相同。
经验丰富的外科医生和经验不足的外科医生使用髓内钉治疗股骨粗隆间骨折的并发症在统计数据上无显著差异。尽管经验不足的外科医生手术时手术时间和输血量显著更长、更多,但在并发症和再次手术必要性方面表现令人满意。