Abstract:
:The aim of this non-randomised prospective study was to evaluate the short-term outcome of Gamma nail and dynamic hip screw (DHS) fixation in the treatment of subtrochanteric hip fractures due to low-energy trauma in the elderly. All of the 1,624 femoral hip fractures in 1,511 patients of the Oulu Hospital, aged over 49 years, were prospectively registered from 1991-1999 using special forms. Seventy-three (4.5%) of the fractures were subtrochanteric. After exclusions, 58 patients constituted the final study group. Of these, 43 were treated with Gamma nails and 15 with DHS. Background factors before the fracture, complications, reoperations and functional parameters at 4 months were recorded using standardised forms. Intraoperative and hospital data were collected from patient records. The Seinsheimer fracture types IIIA, IIC and V were the most common fracture patterns when the Seinsheimer classification system was used, and Fielding II and AO 31A3.3, respectively, were the most common types in the Fielding and AO classification system. There were four (9%) intraoperative complications in the Gamma nail group as compared to none in the DHS group. On the other hand, postoperative complications were more common in the DHS group (27%) than in the Gamma nail group (7%). We recognised a correlation between certain fracture types and the likelihood of typical intra- or postoperative complications or difficulties with both devices: In Gamma nailing, difficulty in closed reduction as well as the rate of open reduction and the use of supplementary fixation were most frequent in the Seinsheimer IIC fractures. It is also noticeable that all of the postoperative device failures and fracture displacements of the DHS group occurred in the Seinsheimer type IIIA category. Detailed fracture classification is essential for the choice of the fixation device, and the present study confirms the presumption that, despite the perioperative problems associated with Gamma nailing, this technique may be preferable to plate fixation for specific fracture types with medial cortical comminution, such as Seinsheimer type IIIA.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Saarenpää I,Heikkinen T,Jalovaara Pdoi
10.1007/s00264-006-0088-9subject
Has Abstractpub_date
2007-02-01 00:00:00pages
65-70issue
1eissn
0341-2695issn
1432-5195journal_volume
31pub_type
临床试验,杂志文章abstract::The effect of a low dose of diclofenac sodium, administered locally, on heterotopic bone formation in rats was investigated. Heterotopic bone was induced by implantation of demineralised bone matrix into the gluteal muscles. Diclofenac was released continuously for 2 weeks from micro-osmotic pumps for each demineralis...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00178357
更新日期:1995-01-01 00:00:00
abstract::Patients with osteoarthritis of the knee often require bilateral knee replacement before fulfilling their full ambulatory potential. Despite extensive research there is considerable debate about the risks of performing simultaneous bilateral knee replacements under the same anaesthetic. Our aim was to compare the rela...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-007-0447-1
更新日期:2009-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00264-010-1040-6
更新日期:2011-05-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-017-3429-y
更新日期:2017-05-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-020-04637-3
更新日期:2020-08-01 00:00:00
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journal_title:International orthopaedics
pub_type: 信件
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更新日期:2014-05-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-017-3716-7
更新日期:2018-12-01 00:00:00
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journal_title:International orthopaedics
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更新日期:2009-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-013-2158-0
更新日期:2014-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2008-06-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2017-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2004-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-003-0509-y
更新日期:2004-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:International orthopaedics
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2015-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00183364
更新日期:1990-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,评审
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更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1992-06-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-07-01 00:00:00
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更新日期:2017-01-01 00:00:00