Is proximal femoral nailing of unstable intertrochanteric fractures in the lateral decubitus position without a traction table as safe and effective as on a traction table?

Dogan N., Erturk C., Gulabi D.

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, cilt.53, sa.2, ss.555-560, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 53 Sayı: 2
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.injury.2021.11.017
  • Dergi Adı: INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Abstracts in Social Gerontology, Aerospace Database, CINAHL, Communication Abstracts, EMBASE, MEDLINE, Metadex, SportDiscus, Civil Engineering Abstracts
  • Sayfa Sayıları: ss.555-560
  • Anahtar Kelimeler: Lateral decubitus position, Proximal femoral nailing, Traction table, Unstable intertrochanteric femoral fracture, ANTIROTATION PFNA, FIXATION, INTRAMEDULLARY, COMPLICATIONS, FEMUR
  • Marmara Üniversitesi Adresli: Hayır

Özet

Objectives: Using proximal femoral nailing (PFN) in the lateral decubitus (lateral) position may be an option when no traction table is available. We hypothesized that applying PFN would be effective and reliable in the lateral position without a traction table. To test our hypothesis, we compared the two techniques in a prospective, randomized controlled study. Patients and methods: Eighty patients (> 60 years of age) with unstable intertrochanteric fractures were randomly operated on prospectively in the lateral position without a traction table (Group 1) or in the supine position with a traction table (Group 2) between April 2018 and April 2019. We compared the surgery preparation time, total anesthesia time, duration of surgery, fluoroscopy exposure time, and amount of bleeding between the two procedures. The type-apex distance (TAD), collodiaphyseal angle (CDA), reduction quality, and lag quadrant were measured radiologically. The Harris Hip Score (HHS) was also calculated. Results: The mean follow-up time was 18.5 (14-27) months in Group 1 and 19.9 (14-27) months in Group 2. The mean follow-up time, mean age, sex distribution, and fracture pattern were similar between the groups. The preparation time and total anesthesia time of Group 2 were longer than those of Group 1, and the fluoroscopy time of Group 2 was shorter than that of Group 1 ( p < 0.05). No significant differences in surgical time, bleeding amount, TAD, CDA, target lag quadrant, reduction quality, or the HHS were observed between the two groups. Conclusions: We concluded that PFN is a safe and effective alternative for the treatment of unstable intertrochanteric femoral fractures when a traction table is not available in the operating room. (c) 2021 Elsevier Ltd. All rights reserved.