Department of Orthopedics and Traumatology, Ümraniye Training and Research Hospital, İstanbul, Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Sep;28(9):1328-1334. doi: 10.14744/tjtes.2022.46706.
The aim of the study was to compare the clinical and radiological results of the Verbrugge minimally invasive technique used in AO/OTA 31-A2.2/A2.3 intertrochanteric fracture types with those of the closed reduction technique performed on a traction table.
A retrospective evaluation was made of 671 patients treated in our clinic for intertrochanteric fracture between 2017 and 2020. The patients included in the study were those aged >70 years, applied with intramedullary nailing for an AO/OTA 31-A2.2/A2.3 fracture type, with >1 year of follow-up. Patients were excluded if they did not meet these criteria, if they had a pathological fracture, an open fracture, or a history of hip surgery. A total of 177 patients were accepted for analysis in the study. The patients were separated into two groups as those where reduction was provided with the Verbrugge minimal invasive technique Verbrugge reduction group (VRG) and those with closed reduction applied on a traction table Conventional reduction group (CRG). The reduction quality was evaluated radiologically with the modified Chang method and the varus reduction rates were compared. The clinical results of the groups were compared in respect of time to full weight-bearing mobilization, complication rates, and Harris Hip Scores (HHS).
Varus malreduction was seen less often in the VRG compared to the CRG, the reduction quality was more successful, the patients could be mobilized earlier and the HHSs were better. No significant difference was determined in terms of operating time and complications.
The Verbrugge method can be used in all AO/OTA 31-A2.2/A2.3 intertrochanteric fractures where closed reduction applied on a traction table is not sufficient. This method can be considered to be an effective technique that increases the quality of the fracture reduction, provides protection throughout the operation, and has similar complication rates to those of the conventional reduction method.
本研究旨在比较 Verbrugge 微创技术（用于治疗 AO/OTA 31-A2.2/A2.3 转子间骨折类型）与牵引台上闭合复位技术的临床和影像学结果。
回顾性评估了 2017 年至 2020 年在我院治疗的 671 例转子间骨折患者。研究纳入的患者为年龄>70 岁、采用髓内钉治疗 AO/OTA 31-A2.2/A2.3 骨折类型、随访时间>1 年的患者。不符合这些标准、病理性骨折、开放性骨折或髋关节手术史的患者被排除在外。共有 177 例患者被纳入本研究进行分析。患者分为两组：采用 Verbrugge 微创技术进行复位的患者（Verbrugge 复位组，VRG）和在牵引台上进行闭合复位的患者（常规复位组，CRG）。采用改良 Chang 法评估复位质量，并比较内翻复位率。比较两组患者完全负重活动时间、并发症发生率和 Harris 髋关节评分（HHS）。
与 CRG 相比，VRG 中内翻不良复位发生率较低，复位质量更好，患者可以更早地活动，HHS 更高。两组在手术时间和并发症方面无显著差异。
Verbrugge 法可用于所有 AO/OTA 31-A2.2/A2.3 转子间骨折，对于牵引台上闭合复位效果不佳的患者，可以采用该方法。该方法可提高骨折复位质量，为手术全程提供保护，且并发症发生率与传统复位方法相似，是一种有效的技术。
