Usami Takuya, Takada Naoya, Nishida Kazuki, Sakai Hiroaki, Iwata Hidetoshi, Sekiya Isato, Ueki Yoshino, Murakami Hideki, Kuroyanagi Gen
Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601 Aichi, Japan.
Department of Orthopaedic Surgery, Kainan Hospital, Yatomi, 498-8502 Aichi, Japan.
SICOT J. 2021;7:33. doi: 10.1051/sicotj/2021032. Epub 2021 May 19.
Trochanteric femoral fracture is one of the most common fractures in the elderly. Trochanteric femoral fracture with involvement of the lesser trochanter is considered unstable and recognized as having a poor prognosis. However, fixation of lesser trochanter fragment is scarce because of technical difficulties. In this study, we reported the simple surgical procedure and the effect of using nonabsorbable tape in lesser trochanter fixation.
From January 2014 to December 2017, 114 patients treated with proximal intramedullary nailing for trochanteric fractures with the lesser trochanter fragment were reviewed. Among patients enrolled in this study, 73 were followed up until radiographic bone union, of which 26 were treated with lesser trochanter fragment banding (group B) and 47 without banding (group N). Radiographs and/or computed tomography images were used to evaluate bone union of the lesser trochanter fragment at three months postoperatively.
The bone union of the lesser trochanter fragment was achieved in 24 cases (92%) in group B and 30 cases (64%) in group N. Compared with group N, group B showed a significantly increased number of mild and moderate deformities but decreased number of severe deformity and nonunion (P < 0.001). Postoperative complications were not observed in both groups.
From the viewpoint of increasing lesser trochanteric bone union ratio, fixation of the lesser trochanter fragment using nonabsorbable tape in the treatment of trochanteric fractures could be an effective procedure.
股骨转子间骨折是老年人最常见的骨折之一。累及小转子的股骨转子间骨折被认为是不稳定的，且预后较差。然而，由于技术困难，小转子骨折块的固定较少见。在本研究中，我们报告了一种简单的手术方法以及使用不可吸收带固定小转子的效果。
回顾性分析2014年1月至2017年12月期间114例行近端髓内钉治疗的伴有小转子骨折块的转子间骨折患者。本研究纳入的患者中，73例患者接受随访直至影像学骨愈合，其中26例采用小转子骨折块捆绑固定（B组），47例未行捆绑固定（N组）。术后3个月通过X线片和/或计算机断层扫描图像评估小转子骨折块的骨愈合情况。
B组小转子骨折块骨愈合24例（92%），N组30例（64%）。与N组相比，B组轻度和中度畸形数量显著增加，但重度畸形和骨不连数量减少（P<0.001）。两组均未观察到术后并发症。
从提高小转子骨愈合率的角度来看，在转子间骨折治疗中使用不可吸收带固定小转子骨折块可能是一种有效的方法。
