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动力髁螺钉治疗50岁以上患者不稳定型股骨粗隆间骨折的功能结果

Functional Outcomes of a Dynamic Condylar Screw for Unstable Femoral Intertrochanteric Fractures in Patients Above 50.

作者信息

Abdalla MohammedElhassan, Samir Elrukby Hussein, Mohamed Ahmed, Salih Monzir M

机构信息

Department of Orthopaedics, Gezira Centre for Orthopedic Surgery and Traumatology, Wad Madani, SDN.

Department of Surgery, University of Gezira, Wad Madani, SDN.

出版信息

Cureus. 2024 Sep 7;16(9):e68905. doi: 10.7759/cureus.68905. eCollection 2024 Sep.

Abstract

BACKGROUND

Hip fractures are among the most common fractures encountered in the emergency departments by orthopedic trauma teams. The optimal treatment method and implant choice for unstable intertrochanteric fractures are subject to debate, with various options available, including intramedullary and extramedullary implants.

METHODS

In this descriptive cross-sectional study, the researchers examined patients with unstable intertrochanteric fractures (classified as 31A2 according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification) who had undergone open reduction and internal fixation with a 95° dynamic condylar screw (DCS). The study was conducted at the Gezira Centre for Orthopedic Surgery and Traumatology (GCOST) during the latter half of 2022. Functional outcomes were assessed using the modified Harris Hip Score (mHHS).

RESULTS

A total of 30 patients were enrolled in this study, with a mean age of 73 ± 12.27 years. Of these, 11 (36.7%) were male, and 19 (63.3%) were female. The mHHS was 73.6 ± 14.654. Among the surveyed patients, seven (23.3%) reported poor outcomes, 13 (43.3%) reported fair outcomes, six (20%) reported good outcomes, and four (13.3%) reported excellent outcomes. The Kruskal-Wallis test revealed statistically differences in mean mHHS scores between gender groups (p = 0.024) and between age groups (p = 0.04). However, no significant differences were found across different modes of trauma groups (p = 0.73), affected hip groups (p = 0.35), comorbidity groups (p = 0.84), or postoperative complication groups (p = 0.06).

CONCLUSION

Our study found that DCS treatment for unstable intertrochanteric fractures yielded acceptable functional outcomes, making it a viable and effective treatment option.

摘要

背景

髋部骨折是骨科创伤团队在急诊科遇到的最常见骨折之一。不稳定型股骨转子间骨折的最佳治疗方法和植入物选择存在争议,有多种选择,包括髓内和髓外植入物。

方法

在这项描述性横断面研究中,研究人员检查了接受95°动力髁螺钉(DCS)切开复位内固定术的不稳定型股骨转子间骨折患者(根据AO基金会/骨科创伤协会(AO/OTA)分类为31A2)。该研究于2022年下半年在杰济拉骨外科和创伤学中心(GCOST)进行。使用改良Harris髋关节评分(mHHS)评估功能结果。

结果

本研究共纳入30例患者,平均年龄73±12.27岁。其中,男性11例(36.7%),女性19例(63.3%)。mHHS为73.6±14.654。在接受调查的患者中,7例(23.3%)报告结果较差,13例(43.3%)报告结果一般,6例(20%)报告结果良好,4例(13.3%)报告结果优异。Kruskal-Wallis检验显示,性别组(p = 0.024)和年龄组(p = 0.04)之间的平均mHHS评分存在统计学差异。然而,在不同创伤模式组(p = 0.73)、患侧髋关节组(p = 0.35)、合并症组(p = 0.84)或术后并发症组(p = 0.06)之间未发现显著差异。

结论

我们的研究发现,DCS治疗不稳定型股骨转子间骨折可获得可接受的功能结果,使其成为一种可行且有效的治疗选择。

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