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Gamma-Nagel versus dynamische Kondylenschraube in der Behandlung per- und subtrochantärer femurfrakturen

Gamma nail versus dynamic condylar screw in the treatment of pertrochanteric and subtrochanteric fractures of the femur

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Zusammenfassung

Eine Gruppe von 68 konsekutiv mit Gamma-Nagel versorgten per- bis subtrochantären Femurfrakturen wurde einem historischen Vergleichskollektiv von 68 mit dynamischer Kondylenschraube behandelten Patienten gegenübergestellt. Durchschnittsalter (Gamma-Nagel: 82 Jahre, dynamische Kondylenschraube: 81 Jahre) und Frakturtypen nach AO waren vergleichbar, überwiegend wurden 31-A3.3-Fracturen versorgt. Der Gamma-Nagel verzeichnete kürzere Operationszeiten (73 [30 bis 180] vs. 120 [60 bis 270] Minuten), weniger Zusatzeingriffe (Schrauben, Drahtcerclagen, Spongiosaplastiken, 0 vs. 38), keine Wundinfekte (dynamische Kondylenschraube 6%) und kein Implantatversagen (dynamische Kondylenschraube 6%). Die Ein-Jahres-Überlebensrate war in beiden Kollektiven vergleichbar, jedoch konnten mehr mit Gamma-Nagel behandelte Patienten auf das zum vor dem Unfall bestehende Mobilisationsniveau rehabilitiert werden (Gamma-Nagel 90%, dynamische Kondylenschraube 75%).

Abstract

Sixty-eight pertrochanteric fractures treated with the gamma nail were compared with 68 fractures treated with the dynamic condylar screw. Age (gamma nail: 82 years, dynamic condylar screw: 81 years) and fracture types (AO classification) were comparable, most fractures in both groups were 31-A3.3-fractures. The gamma nail had shorter operation times (73 [30 to 180] vs. 120 [60 to 270] minutes), less additional operative procedures (additional screws, wires, bone grafting, 0 vs. 38), no wound infections (dynamic condylar screw 6%) and no implant failures (dynamic condylar screw 6%). Survival after 1 year was similar in both groups, but more patients treated with the gamma nail (90% vs. 75%) achieved their preoperative level of mobilisation.

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Authors and Affiliations

  1. Abteilung für Unfall- und Wiederherstellungschirurgie, Universitäts-Krankenhaus Eppendorf, Hamburg

    Holger von Kroge, Friederike Grabbe & Johannes Maria Rueger

  2. Abteilung für Unfall- und Wiederherstellungschirurgie, Universitäts-Krankenhaus Eppendorf, Martinistraße 52, D-20246, Hamburg

    Ralf Erik Hilgert

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  1. Ralf Erik Hilgert
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  2. Holger von Kroge
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  3. Friederike Grabbe
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  4. Johannes Maria Rueger
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Correspondence to Ralf Erik Hilgert.

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Hilgert, R.E., von Kroge, H., Grabbe, F. et al. Gamma-Nagel versus dynamische Kondylenschraube in der Behandlung per- und subtrochantärer femurfrakturen. Unfallchirurgie 25, 142–149 (1999). https://doi.org/10.1007/BF00578722

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