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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2018, Number 3

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Acta Ortop Mex 2018; 32 (3)

Functional results and complications of the use of the proximal femoral nail in the treatment of intertrochanteric hip fractures

Vélez M, Palacios-Barahona U, Arango-Posada MM, Ramos-Castañeda J

Language: Spanish
References: 27
Page: 126-130
PDF size: 143.80 Kb.


ABSTRACT

Introduction: Cephalomedullary nails are used for the treatment of hip fractures; however, there are few studies that allow identifying data on the complications of the use of these devices and the results in terms of restoration of the functionality of the patient. Methods: A cross-sectional study of patients with femur fracture was conducted during the period from January 2008 to December 2012. Data on demographic and clinical variables were collected. Telephone follow-up was performed up to six postoperative months. A descriptive analysis was done using absolute and relative frequency measurements. Quantitative variables are presented with averages and standard deviation or median and interquartile range, according to the normality of the data. Results: 82.9% of the patients managed to walk with or without help within six months after surgery; anemia (16.2%), urinary tract infection (9.7%), pneumonia (9.5%) and myocardial infarction (0.7%) were the main complications. Of the patients included, 57.1% had an ASA level ≥ 3; a mortality rate of 16% was identified. Discussion: Cephalomedullary nails show positive results regarding recovery of functional mobility and a low prevalence of complications, with similar mortality to that reported in the literature at 6 months of follow up.


REFERENCES

  1. Hernández, Parra, Morales, Mateus. Mortalidad posterior a fracturas intertrocantéricas antes y después de las 48 horas. Efecto del retraso en el tratamiento quirúrgico. Estudio de casos y controles. [Hospital Universitario Clínica San Rafael]: Universidad Militar Nueva Granada. 2016; 1-19.

  2. Kokoroghiannis C, Aktselis I, Deligeorgis A, Fragkomichalos E, Papadimas D, Pappadas I. Evolving concepts of stability and intramedullary fixation of intertrochanteric fractures—a review. Injury. 2012; 43(6): 686-93.

  3. Calderón A, Ramos T, Vilchez F, Mendoza-Lemus O, Peña V, Cárdenas-Estrada E, et al. Comparación del clavo intramedular femoral proximal (PFN) versus placa DHS para el tratamiento de fracturas intertrocantéricas. Análisis prospectivo. Acta Ortop Mex. 2013; 27(4): 236-9.

  4. Uliana CS, Abagge M, Malafaia O, Kalil-Filho FA, da Cunha LAM. Transtrochanteric fractures: evaluation of data between hospital admission and discharge. Rev Bras Ortop. 2014; 49(2): 121-8.

  5. Gari-Villa EM, de la Peña-Vargas O, Solano-Urrutia AL. Resultados del tratamiento de fracturas intertrocantéricas inestables con clavo cefalomedular bloqueado. Rev Col de Or Tra. 2008; 22(1): 60-6.

  6. Michael R. Baumgaertner MPL. Intertrochanteric hip fractures. In: Browner BD, editor. Skeletal trauma: basic science, management, and reconstruction. 5th ed. Philadelphia, Pa: Elsevier, Saunders; 2015. pp. 1683-720.e3.

  7. Chen PH, Wu CC, Chen WJ. Factors affect stability of intertrochanteric fractures when elderly patients fall. Biomed J. 2016; 39(1): 67-71.

  8. Kates SL, Mendelson DA, Friedman SM. The value of an organized fracture program for the elderly: early results. J Orthop Trauma. 2011; 25(4): 233-7.

  9. Gangadharan S, Nambiar M. Intertrochanteric fractures in elderly high risk patients treated with Ender nails and compression screw. Indian J Orthop. 2010; 44(3): 289-91.

  10. Ballal MS, Emms N, Thomas G. Proximal femoral nail failures in extracapsular fractures of the hip. J Orthop Surg (Hong Kong). 2008; 16(2): 146-9.

  11. Koval KJ. Intramedullary nailing of proximal femur fractures. Am J Orthop (Belle Mead NJ). 2007; 36(4 Suppl): 4-7.

  12. Ken Koval, MD. Biomet Peritrochanteric Nail (PTN) System. Biomet Trauma, Form No. BMET0261.0-GBL • REV0714; 2014.

  13. Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R. The proximal femoral nail (PFN)—a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand. 2003; 74(1): 53-8.

  14. Xu YZ, Geng DC, Mao HQ, Zhu XS, Yang HL. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res. 2010; 38(4): 1266-75.

  15. Sannomiya M, Kajitani M. Comparison of clinical results between CHS and PTN for unstable trochanteric fractures of the femur. J Chugoku-Shikoku Orthop Assoc. 2013; 25(2): 325-31.

  16. Fonseca-Caro JF, Matson-Carballo G, Pereira-Betancourt C, Rivera-Martínez E. Enclavijamiento cefalomedular en el manejo de fracturas inestables de cadera. Rev Cienc Biomed. 2015; 6(2): 265-71.

  17. Nurmi I, Narinen A, Luthje P, Tanninen S. Functional outcome and survival after hip fracture in elderly: a prospective study of 106 consecutive patients. J Orthop Traumatol. 2004; 5(1): 7-14.

  18. Queally JM, Harris E, Handoll HH, Parker MJ. Intramedullary nails for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2014; (9): CD004961.

  19. Uribe-Ríos A, Castaño-Herrera DA, García-Ortega AN, Pardo-Aluma EE. Morbilidad y mortalidad en pacientes mayores de 60 años con fractura de cadera en el Hospital Universitario San Vicente Fundación, de Medellín, Colombia. Iatreia. 2012; 25(4): 305-13.

  20. Del Gordo-D’Amato RJ. Fracturas del fémur proximal. Opciones de tratamiento. Ortho-tips. 2012; 8(3): 157-64.

  21. Temiz A, Durak A, Atici T. Unstable intertrochanteric femur fractures in geriatric patients treated with the DLT trochanteric nail. Injury. 2015; 46 Suppl 2: S41-6.

  22. Pajarinen J, Lindahl J, Michelsson O, Savolainen V, Hirvensalo E. Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation. J Bone Joint Surg Br. 2005; 87(1): 76-81.

  23. Herrera A, Domingo J, Martinez A. Results of osteosynthesis with the ITST nail in fractures of the trochanteric region of the femur. Int Orthop. 2008;32(6):767-72.

  24. Schipper IB, Steyerberg EW, Castelein RM, van der Heijden FH, den Hoed PT, Kerver AJ, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br. 2004; 86(1): 86-94.

  25. Mahecha-Tautiva CF, Montt-Salcedo WE. Resultados del tratamiento de las fracturas intertrocantéricas en el Hospital Universitario Mayor Meredí. Bogotá: Universidad De Nuestra Señora Del Rosario, Escuela de Medicina y Ciencias de la Salud; 2015. 1-18.

  26. Folbert EC, Hegeman JH, Gierveld R, van Netten JJ, Velde DV, Ten Duis HJ, et al. Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment. Arch Orthop Trauma Surg. 2017; 137(4): 507-15.

  27. Henderson CY, Ryan JP. Predicting mortality following hip fracture: an analysis of comorbidities and complications. Ir J Med Sci. 2015; 184(3): 667-71.




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