Abstract
We investigated whether a proximal femoral nail (PFN) having two lag screws can be implanted without distal locking screws in AO/OTA 31-A1 and 31-A2 intertrochanteric femur fractures. Twenty-four patients with AO/OTA 31-A1 and 31-A2 fractures were treated with a PFN without distal interlocking by a single surgeon. The mean follow-up was 12 months (range: 7–23). Clinical and functional outcome was assessed according to the Harris hip score and Barthel’s activity score. The fractures healed in all patients; the average consolidation time was 14 weeks (range: 9–28). Fourteen patients had excellent and good results, nine patients had fair results, and one patient had a poor result according to the Harris hip score; 17 patients had a high range of mobility according to the Barthel activity score. Our results suggested that the PFN can be successfully implanted without distal interlocking in 31-A1 and 31-A2 fractures.
Résumé
L’objectif est d’analyser les résultats de l’enclouage fémoral sans verrouillage distal pour des fractures inter trochantériennes de type AO/OTA31-A1 et 31-A2. Matériel et méthodes : 24 patients présentant ce type de fracture ont été traités par un enclouage fémoral proximal sans verrouillage par le même chirurgien. Le suivi moyen a été de 12 mois (7 à 23). Les résultats cliniques et fonctionnels ont été analysés selon le score de Harris et selon le score d’activité de Barthel. Résultats : toutes les fractures ont consolidé chez tous les patients. Le temps de consolidation moyen a été de 14 semaines (de 9 à 28 semaines). 14 patients ont eu un excellent résultat, 9 patients un résultat moyen et un un résultat médiocre selon le score de Harris. 17 patients avaient une bonne mobilité de la hanche selon le score de Barthel. En conclusion : nos résultats permettent de penser que la fracture inter trochantérienne du fémur proximal peut être traitée de façon positive avec un clou fémoral sans verrouillage distal pour des fractures de type 31-A1 et 31-A2.
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Ozkan, K., Unay, K., Demircay, C. et al. Distal unlocked proximal femoral intramedullary nailing for intertrochanteric femur fractures. International Orthopaedics (SICOT) 33, 1397–1400 (2009). https://doi.org/10.1007/s00264-008-0673-1
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DOI: https://doi.org/10.1007/s00264-008-0673-1