The suitable fixation for unstable intertrochanteric fractures

Abstract

Background: Normally taking the surgery is the standard treatment, between sliding hip screw (SHS) and utilizing proximal femoral nail antirotation (PFNA) for intramedullary fixation, it is still not certain which one work better for this type of fracture. Our purpose for this study was to determine the optimum choice of implant for a patient with an unstable intertrochanteric fracture. Methods: In our hospital, a reflective analysis was conducted of all unstable intertrochanteric fractures treated with either a SHS or PFNA fixation between February 2015 and February 2018. The rules of choosing patients were the following: older age of more than 60, unstable intertrochanteric fractures, and willingness to take clinical and radiographic follow-up researches for over 12 months. In this case, patients bearing former hip surgery at any side were removed from the candidates. Demographic characteristics collected effective information including gender, date of operation, and other relevant information. Postoperative outcome measures included operation time, total blood loss amount, validated mobility score, surgery-related syndrome, and tip-apex length. The patients were re-examined at three time periods: 3 weeks, 3 months, and 1 year. The result of P < .05 was considered to be statistically significant. Results: We were able to directly compare the outcomes of PFNA vs SHS techniques and might reveal a better technique in treatment of an unstable intertrochanteric fracture. Trial registration: This study protocol has been registered in Research Registry (researchregistry6057).

Intracortical Screw Insertion Plus Limited Open Reduction in Treating Type 31A3 Irreducible Intertrochanteric Fractures in the Elderly

“…Therefore, limited open reduction is recommended if closed reduction is ineffective for irreducible intertrochanteric fractures [5,[11][12][13][14][15][16], typically type 31A3 fractures as discussed in the present study.…”

Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

“…Besides, these fractures can hardly be corrected by increasing the traction weight. Type 31A1.3, 31A2 and 31A3 are irreducible intertrochanteric fractures[ 4 - 7 , 10 , 11 ]. In 2017, Chinese researchers[ 10 ] proposed the classification and treatment principles for irreducible intertrochanteric fractures.…”

“…According to the existing research, the overall failure rate of surgery is higher for these fractures. Therefore, limited open reduction is recommended if closed reduction is ineffective for irreducible intertrochanteric fractures[ 5 , 11 - 16 ], typically type 31A3 fractures as discussed in the present study.…”