The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study
Abstract Background There is no consensus about intertrochanteric fractures with lateral wall treated with intramedullary nail—proximal femoral nail antirotation (PFNA). The aim of the present study was to compare function outcomes between lateral wall and no lateral wall fractures after surgery by...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-023-01332-y |
| _version_ | 1797453462876717056 |
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| author | Yunfeng Tang Dong Wang Limin Wang Wei Xiong Qian Fang Wei Lin Guanglin Wang |
| author_facet | Yunfeng Tang Dong Wang Limin Wang Wei Xiong Qian Fang Wei Lin Guanglin Wang |
| author_sort | Yunfeng Tang |
| collection | DOAJ |
| description | Abstract Background There is no consensus about intertrochanteric fractures with lateral wall treated with intramedullary nail—proximal femoral nail antirotation (PFNA). The aim of the present study was to compare function outcomes between lateral wall and no lateral wall fractures after surgery by PFNA. Methods This retrospective study evaluated patients with or without lateral wall fractures who underwent PFNA between January 2015 and June 2018. The operative time, intraoperative blood loss, time to fracture healing, complications and functional outcomes qualified by Harris hip score and Parker − Palmer mobility score (PPMS) were compared between the two groups. Results Two groups were comparable with regard to patient age, sexual distribution, mechanism of injury, fracture type, body mass index (BMI), Time to surgery, American Society of Anesthesiologists (ASA) score and quality of reduction. The incomplete group had a longer operation time (54.1 ± 8.74 min vs. 51.0 ± 9.86 min) and more intraoperative blood loss (228.4 ± 48.8 ml vs. 151.3 ± 43.5 ml) in comparison with the control group (P < 0.01). Regarding functional outcome, the HHSs of the two groups were 76.2 ± 11.6 vs 75.6 ± 12.5 at the 3 months (P = 0.603), 81.9 ± 9.4 vs 82.6 ± 8.7 at the six months (P = 0.224), 83.8 ± 6.6 vs 84.5 ± 6.0 at the twelve months 85.2 ± 5.5 vs 86.0 ± 5.8 at the twenty-four months (P > 0.05), respectively. Similar results were obtained about PPMS. We found no difference in Weight bearing time, Time of fracture healing, and Complications between incomplete group and intact group. Conclusions There is no substantial difference in functional results or complication rates for intertrochanteric fractures with lateral wall fractures, except from increased blood loss and operation time. We believe that an intramedullary nail will be sufficient to repair an intertrochanteric fracture with or without a lateral wall fracture. |
| first_indexed | 2024-03-09T15:23:11Z |
| format | Article |
| id | doaj.art-2b28393e1f204e81a6edd2c0db442cf4 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-09T15:23:11Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-2b28393e1f204e81a6edd2c0db442cf42023-11-26T12:42:08ZengBMCEuropean Journal of Medical Research2047-783X2023-09-012811710.1186/s40001-023-01332-yThe PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort studyYunfeng Tang0Dong Wang1Limin Wang2Wei Xiong3Qian Fang4Wei Lin5Guanglin Wang6Trauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityWest China Women’s and Children’s HospitalTrauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan UniversityAbstract Background There is no consensus about intertrochanteric fractures with lateral wall treated with intramedullary nail—proximal femoral nail antirotation (PFNA). The aim of the present study was to compare function outcomes between lateral wall and no lateral wall fractures after surgery by PFNA. Methods This retrospective study evaluated patients with or without lateral wall fractures who underwent PFNA between January 2015 and June 2018. The operative time, intraoperative blood loss, time to fracture healing, complications and functional outcomes qualified by Harris hip score and Parker − Palmer mobility score (PPMS) were compared between the two groups. Results Two groups were comparable with regard to patient age, sexual distribution, mechanism of injury, fracture type, body mass index (BMI), Time to surgery, American Society of Anesthesiologists (ASA) score and quality of reduction. The incomplete group had a longer operation time (54.1 ± 8.74 min vs. 51.0 ± 9.86 min) and more intraoperative blood loss (228.4 ± 48.8 ml vs. 151.3 ± 43.5 ml) in comparison with the control group (P < 0.01). Regarding functional outcome, the HHSs of the two groups were 76.2 ± 11.6 vs 75.6 ± 12.5 at the 3 months (P = 0.603), 81.9 ± 9.4 vs 82.6 ± 8.7 at the six months (P = 0.224), 83.8 ± 6.6 vs 84.5 ± 6.0 at the twelve months 85.2 ± 5.5 vs 86.0 ± 5.8 at the twenty-four months (P > 0.05), respectively. Similar results were obtained about PPMS. We found no difference in Weight bearing time, Time of fracture healing, and Complications between incomplete group and intact group. Conclusions There is no substantial difference in functional results or complication rates for intertrochanteric fractures with lateral wall fractures, except from increased blood loss and operation time. We believe that an intramedullary nail will be sufficient to repair an intertrochanteric fracture with or without a lateral wall fracture.https://doi.org/10.1186/s40001-023-01332-yIntertrochanteric fracturesLateral wallProximal femoral nail antirotation |
| spellingShingle | Yunfeng Tang Dong Wang Limin Wang Wei Xiong Qian Fang Wei Lin Guanglin Wang The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study European Journal of Medical Research Intertrochanteric fractures Lateral wall Proximal femoral nail antirotation |
| title | The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study |
| title_full | The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study |
| title_fullStr | The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study |
| title_full_unstemmed | The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study |
| title_short | The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study |
| title_sort | pfna in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients a retrospective cohort study |
| topic | Intertrochanteric fractures Lateral wall Proximal femoral nail antirotation |
| url | https://doi.org/10.1186/s40001-023-01332-y |
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