Nahouli Hasan, Bassil Daniel, Mailhac Aurelie, Der-Boghossian Asdghig, Tamim Hani, Al Taki Muhyeddine
Department of Orthopedic Surgery, American University of Beirut Medical Center, Beirut, LBN.
Clinical Research Institute, American University of Beirut Medical Center, Beirut, LBN.
Cureus. 2023 Mar 26;15(3):e36706. doi: 10.7759/cureus.36706. eCollection 2023 Mar.
Background Hip fractures, including intertrochanteric and subtrochanteric fractures, are among the most common types of fractures. The dynamic hip screw (DHS) and the cephalomedullary hip nail (CHN) are the two main techniques used for the fixation of these types of fractures. This study aims to explore the association of the fracture type with the use of walking assistance devices post-surgery, regardless of the fixation technique. Methodology This study is a retrospective study based on the review of de-identified patient data from the American College of Surgeons National Surgical Quality Improvement Program database. Patients aged 65 years old or above who underwent fixation procedures for intertrochanteric or subtrochanteric fractures using CHN or DHS techniques were included in this study. Results A total of 8,881 patients were included and divided into the following two groups: 876 (9.9%) patients treated for subtrochanteric fracture, and 8,005 (90.1%) patients treated for intertrochanteric fracture. No statistical significance was detected in the use of mobility aid postoperatively between the two groups. When compared to CHN, DHS was noted to be the most employed fixation technique among patients with intertrochanteric fractures. One main finding was that patients who underwent surgery using DHS for intertrochanteric fractures were more likely to use walking assistance devices postoperatively compared to those with subtrochanteric fractures treated with the same fixation technique. Conclusions Findings suggest that the use of walking assistance devices post-surgery is independent of the type of fracture and potentially dependent on the fixation technique employed. Future studies focused on the difference in the use of walking assistance devices based on fixation techniques for patients with distinctive sub-types of trochanteric fractures are highly encouraged.
髋部骨折，包括粗隆间骨折和粗隆下骨折，是最常见的骨折类型之一。动力髋螺钉（DHS）和髓内髋螺钉（CHN）是用于固定这些类型骨折的两种主要技术。本研究旨在探讨骨折类型与术后使用步行辅助装置之间的关联，而不考虑固定技术。
本研究是一项回顾性研究，基于对美国外科医师学会国家外科质量改进计划数据库中去识别化患者数据的审查。本研究纳入了年龄在65岁及以上、使用CHN或DHS技术进行粗隆间或粗隆下骨折固定手术的患者。
共纳入8881例患者，分为以下两组：876例（9.9%）粗隆下骨折患者，8005例（90.1%）粗隆间骨折患者。两组术后使用移动辅助器具的情况无统计学差异。与CHN相比，DHS是粗隆间骨折患者中最常用的固定技术。一个主要发现是，与采用相同固定技术治疗的粗隆下骨折患者相比，采用DHS治疗粗隆间骨折的患者术后更有可能使用步行辅助装置。
研究结果表明，术后使用步行辅助装置与骨折类型无关，可能取决于所采用的固定技术。强烈鼓励未来开展针对不同亚型粗隆部骨折患者，基于固定技术探讨步行辅助装置使用差异的研究。
