Hoyt Benjamin W, Walsh Sarah A, Tintle Scott M, Andersen Romney C
USU-Walter Reed Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
Orthopaedic Surgery, Riverside Regional Medical Center, Newport News, Virginia.
J Surg Orthop Adv. 2023 Spring;32(1):36-40.
Intertrochanteric femur fractures are associated with high morbidity/mortality, necessitating strategies to limit time under anesthesia, blood loss, and additional trauma while achieving maximal fixation in osteopenic bone. The Orthopedic Designs North America, Inc. Talon DistalFix Femoral Nail System uses deployable barbs to maximize axial and rotational control without distal interlock screws. The purpose of this study was to evaluate perioperative features and postoperative outcomes in patients treated with the DistalFix Femoral Nailing System for isolated intertrochanteric femur fractures. Seventy-one consecutive patients underwent intramedullary fixation for isolated intertrochanteric fractures with the DistalFix system between January 2019-July 2020. Median operative time was 35 (33 - 40) minutes. Median estimated blood loss was 125 (75 - 150) cc. Median fluoroscopy time was 2.4 (2.2 - 2.9) minutes and dosage was 27.1 (18.0 - 35.2) mGy. Union occurred in 98% of patients; none experienced implant cutout, and 81.1% returned to previous mobility. The DistalFix system achieves a high rate of union and return to function while limiting operative risk factors. (Journal of Surgical Orthopaedic Advances 32(1):036-040, 2023).
股骨粗隆间骨折与高发病率/死亡率相关，因此需要采取策略来限制麻醉时间、减少失血和避免额外创伤，同时在骨质疏松的骨骼中实现最大程度的固定。北美骨科设计公司的Talon DistalFix股骨钉系统使用可展开的倒刺，在不使用远端锁定螺钉的情况下实现轴向和旋转控制的最大化。本研究的目的是评估使用DistalFix股骨钉系统治疗孤立性股骨粗隆间骨折患者的围手术期特征和术后结果。2019年1月至2020年7月期间，71例连续患者使用DistalFix系统接受了孤立性粗隆间骨折的髓内固定。中位手术时间为35（33 - 40）分钟。中位估计失血量为125（75 - 150）cc。中位透视时间为2.4（2.2 - 2.9）分钟，剂量为27.1（18.0 - 35.2）mGy。98%的患者实现了骨愈合；无一例出现植入物穿出，81.1%的患者恢复到之前的活动能力。DistalFix系统在限制手术风险因素的同时，实现了高骨愈合率和功能恢复率。（《外科骨科进展杂志》32(1):036 - 040, 2023）
