Ryu Hyung-Gon, Choi Youn-Taek, Kim Sang-Min, Seo Jae-Sung
Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.
Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.
Hip Pelvis. 2020 Mar;32(1):50-57. doi: 10.5371/hp.2020.32.1.50. Epub 2020 Feb 26.
To compare outcomes (i.e., clinical and radiological findings, postoperative complication) in the fixation of intertrochanteric fractures with U-blade Gamma3 and Gamma3 nails.
A review of 162 patients (both male and female) treated for intertrochanteric fractures between December 2012 and December 2018 was conducted. All patients were older than 65 years of age and treated with U-blade Gamma3 (n=90) or Gamma3 (n=72) nails. Evaluations included: (i) screw-head position, (ii) fracture-reduction status, (iii) time to union, (iv) cases of cut-out, (v) tip-apex distance, and (vi) lag screw sliding distance. Differences in pre- and postoperative ambulatory ability was also investigated.
There were no significant differences in baseline demographics between the two groups. While the lag-screw sliding distance was significantly shorter in U-blade Gamma3 nail group (4.7 mm vs. 3.6 mm; =0.025), the mean time to union was similar between the groups (=0.053). Three and six cases of cut-out were noted in the U-blade Gamma3 and Gamma3 nail groups, respectively (=0.18), however no other postoperative complications were noted in either group. Lastly, there was no difference between the change from pre- to postoperative activity level between the groups (=0.753).
Of all the clinical and radiological outcomes assessed, the only significant improvement between those treated with U-Blade Gamma and Gamma3 nails was a shorter lag-screw sliding distance. These findings should benefit clinicians when deciding between the use of U-Blade Gamma or Gamma3 nails.
比较U型刀片式Gamma3钉与Gamma3钉固定股骨转子间骨折的疗效(即临床和影像学表现、术后并发症)。
回顾性分析2012年12月至2018年12月间治疗的162例股骨转子间骨折患者(包括男性和女性)。所有患者年龄均大于65岁,分别采用U型刀片式Gamma3钉(n = 90)或Gamma3钉(n = 72)治疗。评估内容包括:(i)螺钉头部位置;(ii)骨折复位情况;(iii)愈合时间;(iv)穿出病例数;(v)尖顶距;(vi)拉力螺钉滑动距离。同时还研究了术前和术后步行能力的差异。
两组患者的基线人口统计学特征无显著差异。虽然U型刀片式Gamma3钉组的拉力螺钉滑动距离明显更短(4.7 mm对3.6 mm;P = 0.025),但两组的平均愈合时间相似(P = 0.053)。U型刀片式Gamma3钉组和Gamma3钉组分别有3例和6例穿出(P = 0.18),然而两组均未发现其他术后并发症。最后,两组术前至术后活动水平的变化无差异(P = 0.753)。
在所有评估的临床和影像学结果中,使用U型刀片式Gamma钉和Gamma3钉治疗的患者之间唯一显著的改善是拉力螺钉滑动距离更短。这些发现将有助于临床医生在选择使用U型刀片式Gamma钉或Gamma3钉时做出决策。