Clinical and Radiological Outcomes of Trochanteric AO/OTA 31A2 Fractures: Comparison between Helical Blade and Lag Screw – A Retrospective Cohort Study

Sertan Hancıoğlu; Kadir Gem; Hakan Koray Tosyali; Güvenir Okçu

doi:10.1055/a-1291-8619

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2022; 160(03): 278-286
DOI: 10.1055/a-1291-8619

Original Article

Clinical and Radiological Outcomes of Trochanteric AO/OTA 31A2 Fractures: Comparison between Helical Blade and Lag Screw – A Retrospective Cohort Study

Klinische und radiologische Ergebnisse von pertrochantären AO/OTA 31A2 Frakturen: Vergleich von Klinge und Schraube – Eine retrospektive Kohortenstudie

Sertan Hancıoğlu

¹Orthopedics and Traumatology, Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey

,

Kadir Gem

²Orthopedics and Traumatology Clinic, Alasehir State Hospital, Manisa, Turkey

,

Hakan Koray Tosyali

³Orthopedics and Traumatology, Celal Bayar Universitesi Tip Fakultesi, Manisa, Turkey

,

Güvenir Okçu

³Orthopedics and Traumatology, Celal Bayar Universitesi Tip Fakultesi, Manisa, Turkey

› Author Affiliations

Abstract

Introduction The purpose of this study was to compare the clinical and radiological outcomes of AO/OTA type 31A2 fractures treated by the use of trochanteric nails either with a blade or a screw.

Patients and Methods This study was designed retrospectively. Between May 2007 and May 2014, a total of 144 patients with trochanteric fractures were admitted to the clinic, and only 65 of them met the inclusion criteria. Thirty-two of them (blade group) were treated with a helical blade and the rest of the 33 patients (screw group) were treated with a screw. The mean ages of the patients were 76.01 and 75.82, respectively (p = 0.905). The mean follow-up time was 27.6 months (blade group: 34.2 ± 19.1 months; screw group: 18.6 ± 7.9 months; p < 0.001). Between these two groups, we evaluated the differences in tip apex distances (TAD), calcar-referenced tip-apex distances (Cal-TAD), implant positions, cut-out rates, and implant failures. Functional outcomes were measured with the help of the Harris Hip Score.

Results No significant differences were seen between the blade and screw groups by means of cutting out, implant positions, and varus collapse. Cutting out was seen in a total of six patients (blade group n = 2; screw group = 4; p = 0.672) and varus collapse in nine patients (blade group n = 5, screw group n = 4; p = 0.733). Harris Hip Scores were similar between the two groups (blade group: 72.70 ± 18.43; screw group: 80.83 ± 18.75; p = 0.84).

Zusammenfassung

Einleitung Das Ziel dieser Studie ist die Untersuchung von klinischen und radiologischen Ergebnisse von pertrochantären AO/OTA 31A2 Frakturen, die mit proximalen Femurnagel (PFN), entweder mit Klinge oder Schraube als Schenkelhals-implantat, chirurgisch versorgt sind.

Patienten und Methoden Diese Arbeit ist eine retrospektiv durchgeführte Kohortenstudie. Im Zeitraum von Mai 2007 bis Mai 2014 haben sich 144 Patienten mit einer pertrochantären Fraktur an unser Krankenhaus gewandt. Fünfundsechzig von denen haben die Inklusionskriterien erfüllt. PFN mit Klinge wurde bei der Versorgung von den Frakturen von 32 Patienten (Klingengruppe) benutzt, und der Rest der Frakturen (Schraubengruppe, n = 33) wurde mit PFN mit Schraube versorgt. Das Durchschnittsalter betrug 76.01 Jahre in Klingengruppe und 75.82 Jahre in Schraubengruppe (p = 0.905). Die durchschnittliche Nachverfolgungsdauer betrug 27.6 Monaten (Klingengruppe: 34.2 ± 19.1 Monaten; Schraubengruppe: 18.6 ± 7.9 Monaten; p < 0.001). Die beiden Gruppen wurden im Rahmen von Tipp-Apex Abstand (TAD), Calcar referenzierter Tipp-Apex Abstand (Cal-TAD), Implantatenposition, Cut-Out Raten und Fehlschläge von Implantation. Funktionale Ergebnissen wurden mit Hilfe von Harris Hip Score (HHS) bewertet.

Ergebnisse Die beiden Gruppen unterschieden sich nicht im Rahmen von Cut-out, Implantatenposition und Varus-Kollaps. Insgesamt sechs Frakturen resultierten mit Cut-out (Klingengruppe n = 2, Schraubengruppe n = 4; p = 0.672), und neun Frakturen resultierten mit Varus-Kollaps (Klingengruppe n = 5, Schraubengruppe n = 4; p = 0,733). Harris Hip Scores waren ähnlich bei beiden Gruppen (Klingengruppe: 72.70 ± 18.43; Schraubengruppe: 80.83 ± 18.75; p = 0.84).

Key words

helical blade - lag screw - cut-out - trochanteric fracture - proximal femoral nail

Schlüsselwörter

Klinge - Schraube - Cut-out - pertrochantäre Fraktur - proximaler Femurnagel

Full Text

References

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