Guerra Marcelo Teodoro Ezequiel, Giglio Luiz, Leite Bruno Cornelios
Serviço de Ortopedia e Traumatologia, Universidade Luterana do Brasil (Ulbra), Canoas, Brasil.
Serviço de Ortopedia e Traumatologia, Hospital Universitário de Canoas, Canoas, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):64-68. doi: 10.1016/j.rbo.2017.10.008. Epub 2019 Mar 1.
The aim of the present study was to investigate the incidence of pantrochanteric fractures in cases of trochanteric fractures treated with dynamic hip screw in our service.
A sample of 54 patients with trochanteric fractures treated with dynamic hip screws was included in this retrospective study. Preoperative radiographs were evaluated for fracture classification using the Arbeitsgemeinschaft für Osteosynthesefragen (Association for the Study of Internal Fixation, in German)/Orthopedic Trauma Association (AO/OTA) system for the identification of radiographic osteoporosis and for the measurement of the lateral femoral wall thickness. In the immediate postoperative images, the presence of pantrochanteric fracture was evaluated.
The final sample presented an incidence of 16.7% of pantrochanteric fractures. The thickness of the lateral wall was significantly lower in the group with the complication ( < 0.001). Although fractures classified as 31-A2 were more numerous in the group with pantrochanteric fracture, the difference was not statistically significant ( = 0.456).
The percentage of pantrochanteric fractures in this service is in accordance with previous studies. There was an association between lateral femoral wall thickness and the occurrence of iatrogenic fracture of the lateral cortex. There was no significant difference between fracture classification and pantrochanteric fracture, possibly due to sample size.
本研究旨在调查在我们科室采用动力髋螺钉治疗转子间骨折病例中粗隆部骨折的发生率。
本回顾性研究纳入了54例采用动力髋螺钉治疗转子间骨折的患者样本。术前X线片采用德国骨科内固定研究协会(Arbeitsgemeinschaft für Osteosynthesefragen,AO)/骨科创伤协会(Orthopedic Trauma Association,OTA)系统进行骨折分类评估,以识别影像学骨质疏松情况并测量股骨外侧壁厚度。在术后即刻影像中,评估粗隆部骨折的存在情况。
最终样本中粗隆部骨折的发生率为16.7%。出现并发症的组中外侧壁厚度显著更低(P<0.001)。尽管在粗隆部骨折组中分类为31 - A2的骨折更多,但差异无统计学意义(P = 0.456)。
本科室粗隆部骨折的百分比与先前研究一致。股骨外侧壁厚度与外侧皮质医源性骨折的发生之间存在关联。骨折分类与粗隆部骨折之间无显著差异,可能是由于样本量的原因。