Comparison of functional outcomes in patients fixed with dynamic hip screw and proximal femur nail-anti-rotation in a1 and a2 type intertrochanteric femur fractures A1 ve a2 tipi femur intertrokanterik kırıklarında kayan kalça vidası ve proksimal femur çivisi-antirotasyon ile tespit sonrası hastaların fonksiyonel sonuçlarının karşılaştırılması

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Sevinç H. F., Çırpar M., Canbeyli İ. D., Dağlar B., Oktaş B., DURUSOY S.

Ulusal Travma ve Acil Cerrahi Dergisi, cilt.26, sa.5, ss.811-817, 2020 (SCI-Expanded, Scopus, TRDizin) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 5
  • Basım Tarihi: 2020
  • Doi Numarası: 10.14744/tjtes.2020.39888
  • Dergi Adı: Ulusal Travma ve Acil Cerrahi Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.811-817
  • Anahtar Kelimeler: Dynamic hip screw, Femoral neck-shaft angle, Intertrochanteric femur fractures, Proximal femoral nail anti-rotation, Tip-apex distance
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Samsun Üniversitesi Adresli: Hayır

Özet

BACKGROUND: We aimed to compare clinical and functional outcomes between patients treated with Dynamic hip screw (DHS) and Proximal Femoral Nail-Antirotation (PFN-A) implants. METHODS: This study included 122 patients (66 men [54.1%] and 56 women [45.9%]) who underwent surgery with DHS and PFN-A for an intertrochanteric femur fracture and had at least 12 months follow-up. Reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed in early postoperative radiographs. On control visits in months 1, 3, 6 and 12, range of motion, thigh or hip pain, and Trendelenburg positivity were assessed in clinical examination and reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed on radiographs after the union. Patients were assessed using Hip Harris Score after the union. RESULTS: Regardless of implant type used, mean tip-apex distance measured at the immediate postoperative period was 27.6 in patients with implant failure, whereas 21.6 in patients without, indicating a significant difference. Again, mean femoral neck-shaft angle measured at the immediate postoperative period was 123 degree in patients with implant failure, whereas 130 degree in those without, indicating a significant difference. It was found that the femoral neck-shaft angle was <128 degree in all patients with implant failure whereas it was >128 degree in 94% of patients without implant failure at immediate postoperative period. CONCLUSION: The findings regarding femur neck-shaft angle at the immediate postoperative period was <128 degree in all patients with implant failure and that it was ≥128 degree in 94% of patients without implant failure emphasize the importance of anatomic restoration in femur neck-shaft angle during surgery. The finding that mean tip-apex distance was 27.6 mm in patients with implant failure and 21.6 mm in patients without implant failure indicates that the technique is as important as implant type selected for treatment success of the implantation.