Argekar Harshad, Dole Ganesh, Shinde Mahesh, Patel Mihir, Patil Yogeshwari H, Sharma Atharva, Sarwey Kshitij, Datta Renema, Modi Arnav, Sathe Sakshi
Orthopaedics, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R.N. Cooper Muncipal General Hospital, Mumbai, IND.
Cureus. 2024 Oct 5;16(10):e70909. doi: 10.7759/cureus.70909. eCollection 2024 Oct.
Among the most prevalent injuries among the elderly with trivial trauma are trochanteric fractures. Osteoporosis and female sex are additional risk factors. The patient's age, the fracture, their overall health, the amount of time between the fracture and treatment, the effectiveness of the treatment, any concurrent medical care, and the stability of the fixation all affect how well the patient responds to treatment. For its fixation, various implants are used. The main aim of this study is to assess the functional outcome in intertrochanteric fractures using the Harris Hip Scoring in intertrochanteric fractures.
Patients presenting with intertrochanteric femur fracture were evaluated. Written consent was taken from the patient. Radiographic data were collected. Complications and varus collapse evaluated. Functional outcome was assessed with the Harris Hip Scoring system.
The proportion of excellent Harris Hip Evaluation (HHE) scores was the highest in proximal femur nail (PFNA2) at six months follow-up examination, which was 11 (57.19%) more than any method. In the incidence of varus deformity, the proportion was maximum in the case of the dynamic hip screw (DHS) with three patients (33.33%), followed by PFN in 11 patients (28.95%), and the least for PFNA2 in three patients (15.79%).
The mean operative time was lower in the PFN A2 group, and the HHE score values were higher than those of PFN and DHS. This study concludes that these implants have a comparable radiological and functional outcome for unstable intertrochanteric fracture except for less surgical time and blood loss in PFN A2.
在受轻微创伤的老年人中，转子间骨折是最常见的损伤之一。骨质疏松和女性性别是额外的风险因素。患者的年龄、骨折情况、整体健康状况、骨折与治疗之间的时间间隔、治疗效果、任何并发的医疗护理以及固定的稳定性都会影响患者对治疗的反应程度。对于其固定，使用了各种植入物。本研究的主要目的是使用转子间骨折的Harris髋关节评分来评估转子间骨折的功能结果。
对出现股骨转子间骨折的患者进行评估。获得了患者的书面同意。收集了放射学数据。评估了并发症和内翻塌陷情况。使用Harris髋关节评分系统评估功能结果。
在六个月的随访检查中，股骨近端髓内钉（PFNA2）的Harris髋关节评估（HHE）优秀评分比例最高，比任何方法都多11例（57.19%）。在内翻畸形发生率方面，动力髋螺钉（DHS）的比例最高，有3例患者（33.33%），其次是PFN，有11例患者（28.95%），而PFNA2最少，有3例患者（15.79%）。
PFN A2组的平均手术时间较短，HHE评分值高于PFN和DHS。本研究得出结论，对于不稳定的转子间骨折，除了PFN A2手术时间较短和失血量较少外，这些植入物在放射学和功能结果方面具有可比性。
