Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However...Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the c展开更多
<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protoc...<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-o展开更多
文摘Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the c
文摘<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-o
