当前位置： SCI文献检索 > JOURNAL OF ORTHOPAEDIC TRAUMA期刊下所有文献 > Does the Angle of the Nail Matter for Pertrochanteric Fracture Reduction? Matching Nail Angle and Native Neck-Shaft Angle.

Does the Angle of the Nail Matter for Pertrochanteric Fracture Reduction? Matching Nail Angle and Native Neck-Shaft Angle.

Abstract：

OBJECTIVES:To determine whether fixation of pertrochanteric hip fractures with cephalomedullary nails (CMNs) with a neck-shaft angle (NSA) less than the native NSA affects reduction and lag screw cutout. DESIGN:Retrospective comparative study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Patients treated with a CMN for unstable pertrochanteric femur fractures (OTA/AO 31-A2.2 and 31-A2.3) between 2005 and 2014. INTERVENTION:CMN fixation. MAIN OUTCOME MEASUREMENT:NSA reduction and lag screw cutout. RESULTS:Patients fixed with a nail angle less than their native NSA were less likely to have good reductions [17% vs. 60%, 95% confidence interval (CI), -63% to -18%; P = 0.0005], secondary to more varus reductions (41% vs. 10%, 95% CI, 9%-46%; P = 0.01) and more fractures with ≥4 mm of displacement (63% vs. 35%, 95% CI, 3%-49%; P = 0.03). The cutout was not associated with the use of a nail angle less than the native NSA (60% vs. 76%, 95% CI, -56% to 18%; P = 0.5), varus reductions (60% vs. 32%, 95% CI, -13% to 62%; P = 0.3), or poor reductions (20% vs. 17%, 95% CI, -24% to 44%; P = 1.0). CONCLUSIONS:The fixation of unstable pertrochanteric hip fractures with a nail angle less than the native NSA was associated with more varus reductions and fracture displacement but did not affect the lag screw cutout. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

journal_title

Journal of orthopaedic trauma

authors

Parry JA,Barrett I,Schoch B,Yuan B,Cass J,Cross W

doi

10.1097/BOT.0000000000001096

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

174-177

issue

4

eissn

0890-5339

issn

1531-2291

journal_volume

32

pub_type

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