|
The StabilityScore of the Intramedullary Nailed Intertrochanteric Fractures: Stability ofNailed Fracture and Postoperative Patient Mobilization Sung-Rak Lee, MD, Seong-Tae Kim, MD, Min Geun Yoon, MD, Myung-Sang Moon, MD, and Jee-Hyun Heo, MD Author information ? Article notes ? Copyright and Licenseinformation ? Departmentof Orthopaedic Surgery and Traumatology, ChejuHalla GeneralHospital, Jeju, Korea. Abstract Background Intertrochanteric fractures of the femur are the mostcommon type of fracture, and are an increasing occurrence due to the aging ofthe population. The objectives of our study are to predict the fate ofintertrochanteric fractures treated with intramedullary hip nails by assessingthe postoperative fracture stability utilizing the newly developed scoringsystem, and to help rehabilitate these patients. 人口老龄化使转子间骨折发生率越来越高。本研究目的是使用一套新的评分系统预测转子间骨折用髓内钉固定后骨折的稳定性，帮助病人的康复。 Methods Eighty-two patients with intertrochanteric fractures thatwere treated with intramedullary hip nails between December, 2004 and January,2011 were subjected to this study. The patients who could be followed for aminimum of one year postoperatively were enrolled. The immediate postoperativeconditions were determined by radiograms: reduction status (3 parameters/4points: contact accuracy of posteromedial cortex, severity of angulation, anddistraction), fixation status (3 parameters/3 points: tip-apex distance,location of tip of the lag screw, entry point of the intramedullary nail), andfracture type (1 parameter/1 point: stable or unstable type by the Kyle'sclassification). Postoperative reduction loss and fixation failure were checkedby radiograms taken at a minimum 3 months postoperative. 2004年12月至2011年1月，82例转子间骨折髓内钉固定。病人术后最少随访一年以上。术后情况放射片评价：复位情况（3参数/4点：后内侧皮质精确复位，骨折成角和分离），固定情况（3参数/3点：尖顶距，螺钉尖位置，髓内钉进钉点）和骨折分型（1参数/1点：骨折稳定和不稳定Kyle's分型）。术后3月一次拍片评价复位丢失和固定失败情况。 Results Reduction loss and fixation failure were observed in 14consecutive patients (17%). The fixation failure rate was 100% (2 patients) inscore 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups.There were fixation failures only in 1 out of 13 patients with score 5, and in1 out of 18 patients with score 6. There was no fixation failure in 17 patientswith score 7 and 11 patients with score 8. 术后14（17%）例病人出现复位丢失和固定失败。评分为1的固定失败率100%（2例），2分病人60%（5例病人3例失败），3分39%（8个病人3例失败），4分50%（8例病人4个失败）。13例5分病人中仅有一例固定失败。8例6分病人中也有一例失败。17例7分病人和11例8分病人中无一例失败。 Conclusions Maintenance of the fracture reduction by the stablefixation in the patient scores over 5 could be predicted by the postoperativeradiograms. 术后即时拍片评分在5分以上病人可以预测能够维持骨折复位固定可靠。 Keywords: Intertrochanteric,Fracture, Intramedullary hip nail, Fixation stability score  
|
|
|
