Chinese PLA Medical School, No.28 Fuxing Road, Haidian, Beijing, 100853, China.
Department of Orthopaedics, the First Medical Center, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian, Beijing, 100853, China.
BMC Musculoskelet Disord. 2022 Nov 29;23(1):1028. doi: 10.1186/s12891-022-06004-2.
Hip-preserving revision in patients with failed treatment of femoral trochanteric fracture is still a major challenge. Whether the medial support reconstruction could benefit the patients and improve the success rate of hip-preserving revision is still controversial. Hence, the purpose of this study was to evaluate the clinical significance and prognosis of medial support reconstruction during the hip-preserving revision of failed femoral trochanteric fracture treatment.
Patients with failed femoral trochanteric fractures treatments addressed by hip-preserving revision at our hospital from January 2014 to December 2020 were analyzed retrospectively. 31 patients were included and divided into a medial support group (n = 16) and a non-medial support group (n = 15). The fracture healing rate was the primary measurement. In addition, the differences in Oxford Hip Score (OHS), quality of life, surgical trauma, and complications were also evaluated.
The fracture healing rate (100%, 16/16 vs. 66.67%, 10/15), the OHS (42.06 ± 4.12 vs. 30.93 ± 11.56, M ± SD), and the mental component score of the 12-item Short-Form Survey (SF-12) (54.48 ± 5.38 vs. 47.90 ± 3.47, M ± SD), were significantly better and the incidence of complications [0(0/16) vs. 40%(6/15)] was significantly lower in the medial support group than the non-medial support group (p < 0.05). No significant differences in the physical component score of the SF-12, surgical trauma and reduction in collodiaphyseal angle of affected femur were observed between groups.
The reconstruction of medial support seems important for revision following failed treatment of femoral trochanteric fractures. Due to the medial augmentation and improvement of the mechanical stability for proximal femur, the patients might benefit from fracture healing prognosis and functional.
对于股骨转子间骨折治疗失败的患者，保髋翻修仍然是一个主要挑战。内侧支撑重建是否能使患者受益并提高保髋翻修的成功率仍存在争议。因此，本研究旨在评估内侧支撑重建在股骨转子间骨折治疗失败的保髋翻修中的临床意义和预后。
回顾性分析 2014 年 1 月至 2020 年 12 月我院收治的股骨转子间骨折治疗失败行保髋翻修的患者。共纳入 31 例患者，分为内侧支撑组（n=16）和非内侧支撑组（n=15）。主要测量指标为骨折愈合率。此外，还评估了牛津髋关节评分（OHS）、生活质量、手术创伤和并发症的差异。
骨折愈合率（100%，16/16 例比 66.67%，10/15 例）、OHS（42.06±4.12 比 30.93±11.56，M±SD）和 12 项简明健康状况调查量表（SF-12）的心理分量表评分（54.48±5.38 比 47.90±3.47，M±SD），内侧支撑组明显优于非内侧支撑组，并发症发生率[0（0/16 例）比 40%（6/15 例）]明显更低（p<0.05）。两组间 SF-12 的生理分量表评分、手术创伤和患侧股骨干骺角的减小无显著差异。
对于股骨转子间骨折治疗失败的翻修，内侧支撑的重建似乎很重要。由于内侧加强和改善了股骨近端的机械稳定性，患者可能从骨折愈合预后和功能中受益。
