We report the results of a prospective randomized clinical trial comparing the Gamma 3 nail with the ACE trochanteric nail for the treatment of pertrochanteric femoral fractures. One hundred and twelve consecutive patients were enrolled in the study: 61 patients were treated with the Gamma 3 nail, 51 with the ACE trochanteric nail. The two groups were matched for age, fracture type and preoperative Merle d'Aubigné hip score. All patients were followed up clinically and radiographically on a regular basis between 6 weeks and one year postoperatively. Twenty-six patients (23%) died within the first postoperative year. Six patients were lost to follow-up. In each group, two patients were revised due to mechanical failure. Nonunion did not occur. The mean postoperative hip scores in the Gamma 3 and the ACE group were 14.19 and 14.12 respectively, with no significant difference (p = 0.92). Walking ability was adequately restored in approximately 80% of the patients. Both implants appeared as safe and effective methods of treatment for intertrochanteric hip fractures.
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Eur J Med Res
December 2024
Department of Orthopedics, The Yangzhou School of Clinical Medicine of Dalian Medical University, Yangzhou, Jiangsu, China.
Objectives: To identify independent risk factors for perioperative hidden blood loss (HBL) in intertrochanteric femoral fractures (ITFs) and to develop a predictive model.
Methods: We enrolled 231 patients with ITFs who underwent proximal femoral nail antirotation (PFNA) surgery at the Orthopedics Department of Northern Jiangsu People's Hospital, Jiangsu Province, China, from January 2021 to December 2023. Hidden blood loss was calculated using the OSTEO formula, and independent risk factors were screened using the Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression.
J Orthop Surg Res
December 2024
Department of Orthopaedics, Fuzhou Second General Hospital, Fujian Medical University, Fuzhou, 350007, China.
Objective: Chinese herbal medicine (CHM) is extensively utilized in managing hidden bleeding following an intertrochanteric femur fracture (IFF). Despite its widespread use, the most effective CHM approach for addressing hidden bleeding post-IFF remains unclear. A Bayesian network meta-analysis was conducted to identify a CHM that both effectively reduces hidden bleeding and stabilizes blood volume after IFF.
View Article and Find Full Text PDFCureus
November 2024
Diabetes and Endocrinology, National Institute of Diabetes, Nutrition and Metabolic Diseases-Prof. N. Paulescu, Bucharest, ROU.
Fractures of the trochanteric mass represent a significant proportion of hip fractures. These fractures often occur in the elderly due to compromised bone quality, leading to a high predisposition for instability at the fracture site. The study was conducted through a retrospective analysis of 1,259 hospitalizations in the Department of Orthopedics and Traumatology of the Bucharest University Emergency Hospital between 2022 and 2023, including patients with various types of trochanteric mass fractures: basicervical, per trochanteric, intertrochanteric, subtrochanteric, and trochanter-diaphyseal fractures.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06200 Yenimahalle, Ankara, Türkiye.
Objectives: This study aimed to investigate the importance of the Dorr index in the preoperative evaluation of implant failure in patients who underwent proximal femoral nail (PFN).
Patients And Methods: This retrospective study examined 312 patients who underwent PFN for intertrochanteric fractures between January 2016 and January 2020. Patients with unstable fractures according to the AO/OTA (AO Foundation/Orthopaedic Trauma Association) classification, those over 65 years of age, with at least one year of regular follow-up, a tip-apex distance <25 mm, and a caput-collum-diaphyseal angle between 125° and 135°, were included.
Cureus
November 2024
Orthopaedics, Virginia Commonwealth University School of Medicine, Richmond, USA.
Distal femoral anterior cortical perforation is a rare complication of intramedullary nailing for proximal femur fractures. Awareness and intraoperative preventive measures are key to minimizing the risk of this complication. We report a case of a patient who experienced an anterior cortical breach of the distal femur during routine antegrade nailing for an intertrochanteric fracture, which was attributed to a sclerotic lesion in the distal femur.
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