Department of Orthopaedic and Trauma Surgery, "Michele e Pietro Ferrero" Hospital, Verduno, CN, Italy.
Department of Public Health, Section of Orthopaedic and Trauma Surgery, Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy.
Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2445-2452. doi: 10.1007/s00590-022-03441-6. Epub 2022 Dec 19.
To compare functional outcomes, complication rates, and survival in patients with intertrochanteric fracture treated with percutaneous compression plate (PCCP) or gamma nail (GN).
A retrospective study of prospectively collected data of patients treated with PCCP or GN for AO/OTA 31.A1 or AO/OTA 31.A2 fractures was conducted. Sixty-eight consecutive patients treated with PCCP between 2018 and 2020 were enrolled and matched with 68 patients with comparable characteristics treated with GN. The activities of daily living (ADL) index and specific scales for walking ability and need for walking aids at 4 months and 1 year after fracture fixation were chosen as primary outcomes. Postoperative complications and one-year survival were recorded and compared between the two groups.
Walking ability and ADLs index decreased and the need for walking aids increased in both groups compared to the prefracture state at both follow-up intervals (p < 0.001), regardless of the treatment received. There was no difference between the two implants in the rate of implant-related complications. One-year survival rate was 78.9% (95% CI 67.0-86.9) and 82.4% (95% CI 71.0-89.5) in patients undergoing PCCP or GN, respectively, with no significant difference between the two groups.
Walking ability, ADLs, complication rate, and 1-year survival are not significantly different when patients undergoing PCCP or GN are compared. The choice of implant may not be decisive for the outcome of treatment of intertrochanteric fractures, provided that stable fixation is ensured.
比较经皮加压钢板（PCCP）和伽马钉（GN）治疗股骨转子间骨折患者的功能结果、并发症发生率和生存率。
对采用 PCCP 或 GN 治疗 AO/OTA 31.A1 或 AO/OTA 31.A2 骨折的前瞻性收集数据进行回顾性研究。纳入了 2018 年至 2020 年间接受 PCCP 治疗的 68 例连续患者，并与接受 GN 治疗的具有可比性特征的 68 例患者进行匹配。选择 4 个月和 1 年后骨折固定后的日常生活活动（ADL）指数和特定行走能力及行走辅助需求量表作为主要结果。记录并比较两组患者的术后并发症和 1 年生存率。
无论接受何种治疗，两组患者在随访期间的行走能力和 ADL 指数均下降，而对行走辅助的需求增加（p<0.001）。两组患者的植入物相关并发症发生率无差异。PCCP 或 GN 组患者的 1 年生存率分别为 78.9%（95%可信区间 67.0-86.9）和 82.4%（95%可信区间 71.0-89.5），两组间无显著差异。
比较接受 PCCP 或 GN 治疗的患者时，行走能力、ADL、并发症发生率和 1 年生存率无显著差异。只要确保稳定固定，植入物的选择可能对股骨转子间骨折治疗结果无决定性影响。
