Direct reduction may need to be considered to avoid postoperative subtype P in patients with an unstable trochanteric fracture: a retrospective study using a multivariate analysis

Naoya Kozono, Satoshi Ikemura, Akihisa Yamashita, Takashi Harada, Tetsuya Watanabe, Kenzo Shirasawa

研究成果: Contribution to journalArticle査読

14 被引用数 (Scopus)

抄録

Introduction: It has recently been reported that the cases with an anterior femoral neck cortex posterior to the distal fragment (subtype P) in the lateral view of a postoperative radiograph have a risk of excessive sliding of lag screws compared to those located anterior to the distal fragment (subtype A) or perfectly continuous to the distal fragment (subtype N) following osteosynthesis for the treatment of a trochanteric fracture. The purpose of this study was to investigate factors that influence the postoperative subtype in the lateral view of radiographs.

Patients and methods: This study reviewed 136 patients who underwent osteosynthesis using an intramedullary hip nail for the treatment of a trochanteric fracture. A closed reduction was performed in 130 patients (95.6 %), while a direct reduction via a small elevator with a small skin incision was performed in the other six patients (4.4 %). The 136 patients were divided into two groups (subtype P and subtype A or N) based on postoperative radiographs taken of the lateral view. Both clinical and radiological factors were analyzed using the univariate and multivariable analyses.

Results: Thirty-nine patients (29 %) were categorized as subtype P and 97 patients (71 %) were categorized as subtype A or N. A multivariate analysis demonstrated that unstable fractures were associated with a significant risk of postoperative subtype P (Odds ratio: 24.45, P = 0.0024).

Conclusions: The results of this study suggest that direct reduction via a small elevator with a small skin incision or percutaneous intrafocal pinning may be needed in these cases.

本文言語英語
ページ(範囲)1649-1654
ページ数6
ジャーナルArchives of Orthopaedic and Trauma Surgery
DOI
出版ステータス出版済み - 2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 整形外科およびスポーツ医学

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