Research Information System
Archives of Basic and Clinical Research, vol.6, no.2, pp.90-95, 2024 (Peer-Reviewed Journal)
Objective: The aim was to compare the clinical and radiological results of trochanter-inserted cephalomedullary locked and trochanter- inserted static transverse locked femoral intramedullary nails in patients over 65 years of age. Methods: Demographic data of the patients, injury mechanism, fracture type, reduction technique, radiological and clinical union in the last follow-up, and complications occurred during the follow-up period were investigated. A subgroup analysis was also conducted to assess the impact of cephalomedullary fixation, and the need for open reduction on wound site infection. Results: A significant correlation was found between the proximal locking technique and periimplantic secondary femoral neck fracture (P = .019). The further risk analysis revealed that static transverse locking system increased the risk of periimplantic femoral neck fracture by 4.8 times (odds ratio (OR) = 4.80, 95% CI: 2.20-10.47). Upon analyzing the parameters that affect wound site infections, a significant correlation was found between the reduction technique and wound site infection (P = .030, OR = 6.60, 95% CI: 1.47-29.66). Conclusion: Cephalomedullary proximal locking is significantly more effective than its alternative, static transverse locking, in preventing periimplantic fractures in antegrade femoral intramedullary nailing of geriatric femoral diaphyseal fractures. Therefore, its routine application in the geriatric population is recommended. It is important to note that open reduction is associated with increased rates of wound-site infection, and closed reduction should be preferred whenever possible.