Rinehart Dustin B, O'Neill David E, Liu Jennifer W, Sanders Drew T
Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX.
J Orthop Trauma. 2021 Jun 1;35(6):329-332. doi: 10.1097/BOT.0000000000001989.
To evaluate the need for reoperation of geriatric intertrochanteric hip fractures treated with 10-mm cephalomedullary nails versus those treated with nails larger than 10 mm.
Retrospective review at a single institution.
Level I trauma center.
PATIENTS/PARTICIPANTS: All patients age 60 and over treated with cephalomedullary fixation for an intertrochanteric femur fracture at a single institution.
Cephalomedullary fixation with variable nail diameters.
Reoperation rates of geriatric intertrochanteric fractures treated with a size 10-mm diameter cephalomedullary nail compared with patients treated with nails larger than 10 mm.
There were no significant differences in reoperation rates when the 10-mm cohort was compared with an aggregate cohort of all nails larger than 10 mm (P = 0.99). This result was true for both all-cause reoperation and noninfectious reoperation. There was no difference between cohorts in regards to age, gender, or fracture pattern.
A 10-mm cephalomedullary nail can be used in lieu of a larger diameter fixation in patients age 60 and older with intertrochanteric femur fractures while still maintaining a comparable rate of reoperation.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估采用10毫米头髓内钉治疗的老年股骨转子间骨折与采用大于10毫米的髓内钉治疗的老年股骨转子间骨折再次手术的必要性。
在单一机构进行的回顾性研究。
一级创伤中心。
患者/参与者：在单一机构接受头髓内固定治疗股骨转子间骨折的所有60岁及以上患者。
采用不同直径髓内钉进行头髓内固定。
比较采用直径10毫米头髓内钉治疗的老年股骨转子间骨折与采用大于10毫米髓内钉治疗的患者的再次手术率。
将10毫米组与所有大于10毫米髓内钉的汇总组进行比较时，再次手术率无显著差异（P = 0.99）。全因再次手术和非感染性再次手术均如此。各队列在年龄、性别或骨折类型方面无差异。
对于60岁及以上的股骨转子间骨折患者，可使用10毫米头髓内钉代替更大直径的固定装置，同时仍能保持相近的再次手术率。
预后III级。有关证据水平的完整描述，请参阅作者须知。
