Goodnough L Henry, Wadhwa Harsh, Tigchelaar Seth S, DeBaun Malcolm R, Chen Michael J, Bishop Julius A, Gardner Michael J
Department of Orthopaedic Surgery, Stanford University School of Medicine, 300 Pasteur Drive Room R144, Stanford, CA, 94305, USA.
Eur J Orthop Surg Traumatol. 2021 Feb;31(2):259-264. doi: 10.1007/s00590-020-02762-8. Epub 2020 Aug 17.
Intra-articular screw cut-out is a potential complication of intertrochanteric femur fracture fixation with a cephalomedullary nail. Cement augmentation of fixation in the proximal segment offers the prospect of increased stability and fewer complications, but clinical experience with non-resorbable cement is limited. To determine the handling properties and efficacy of this new technique, we performed a retrospective propensity-matched cohort of forty-four geriatric intertrochanteric femur fractures treated with a cephalomedullary nail with (n = 11) or without (n = 33) augmentation with non-resorbable cement injected into the proximal segment. In the patients treated with cement augmentation, at minimum 3-month follow-up, there were no instances of intra-articular cut-out, and no increase in re-operation compared to conventional fixation. Cement augmentation appears to be safe and effective in geriatric intertrochanteric femur fractures to mitigate risk of cut-out.
关节内螺钉穿出是使用股骨近端髓内钉治疗股骨转子间骨折的一种潜在并发症。近端节段固定的骨水泥增强可提高稳定性并减少并发症，但不可吸收骨水泥的临床经验有限。为了确定这项新技术的操作特性和疗效，我们进行了一项回顾性倾向匹配队列研究，纳入了44例老年股骨转子间骨折患者，其中11例使用近端节段注入不可吸收骨水泥的股骨近端髓内钉治疗，33例未使用骨水泥增强治疗。在接受骨水泥增强治疗的患者中，至少随访3个月，未出现关节内螺钉穿出的情况，与传统固定相比再次手术率也未增加。骨水泥增强在老年股骨转子间骨折中似乎是安全有效的，可降低螺钉穿出风险。
