CLINICAL OBSERVATION OF Othofix PERTROCHANTERIC FIXATOR FOR FIXATION OF INTERTROCHANTERIC FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIUZengjun ^1,2 ,  SHUHengsheng ² , CHENXu ² , GUOFeng ² , ZHANGKegang ² , LIUYabin ² , SHIBowen ²

1. Graduate College of Tianjin Medical University, Tianjin, 300070, P. R. China;
2. Department of Traumatic Orthopedics, Tianjin Hospital;

Corresponding?author：

SHUHengsheng, Email: drhsshu@hotmail.com

Keywords：

Intertrochanteric fracture; Elderly patient; External fixator

DOI：

10.7507/1002-1892.20160081

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Objective To evaluate the effectiveness of Othofix pertrochanteric fixator for fixation of intertrochanteric fracture. Method A retrospective analysis was made on the clinical data from 36 cases of intertrochanteric fracture treated with Othofix pertrochanteric fixator (OPF group) and 47 cases treated with Gamma nail (Gamma group) between October 2012 and March 2015. There was no significant difference in gender, age, cause of injury, side, AO fracture classification, combined medical disease, and injury to operation time between 2 groups (P>0.05) . The operation time, intraoperative blood loss, hospitalization time, fracture union time, and complication rate were recorded and compared between 2 groups. Hip function was evaluated with Sanders post-trauma criteria. Results The operation time, intraoperative blood loss, and hospitalization time of the OPF group were significantly less than those of the Gamma group (P<0.05) . All the cases were followed up 6-12 months (mean, 8.8 months) in 2 groups. Healing of incision by first intention was obtained. Bone union was achieved in 2 groups, and the fracture union time of the OPF group was significantly shorter than that of the Gamma group (t=14.780, P=0.000) . There was no deep wound or pin track infection in 2 groups. Superficial skin reactions developed around the screw and the pins in 14 cases (38.9%) of the OPF group, but no incision infection in the Gamma group, showing significant difference (χ²=22.010, P=0.001) . Mild varus of the hip and pin cutting-out occurred in 3 cases (8.3%) and 2 cases (5.6%) of the OPF group, and in 4 cases (8.5%) and 3 cases (6.4%) of Gamma group, showing no significant difference (χ²=0.001, P=0.960; χ²=0.025, P=0.830) . According to Sanders post-trauma criteria, the results were excellent in 16 cases, good in 15 cases, fair in 3 cases, and poor in 2 cases, with an excellent and good rate of 86.1% in the OPF group; the results were excellent in 22 cases, good in 20 cases, fair in 4 cases, and poor in 1 case, with an excellent and good rate of 89.4% in the Gamma group; and there was no significant difference (χ²=0.200, P=0.610) . Conclusions The Othofix pertrochanteric fixator has good effectiveness in the treatment of intertrochanteric fracture, which has the advantages of simple operation, less operation time, little bleeding, and early functional recovery.

Citation： LIUZengjun, SHUHengsheng, CHENXu, GUOFeng, ZHANGKegang, LIUYabin, SHIBowen. CLINICAL OBSERVATION OF Othofix PERTROCHANTERIC FIXATOR FOR FIXATION OF INTERTROCHANTERIC FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 402-406. doi: 10.7507/1002-1892.20160081 Copy

1.	Forte ML, Virnig BA, Kane RL, et al. Geographic variation in device use for intertrochanteric hip fractures. J Bone Joint Surg (Am), 2008, 90(4) :691-699.
2.	徐紀慶, 張霆, 侯寶興. 股骨粗隆間骨折治療方法的臨床分析. 中國中醫骨傷科雜志, 2000, 8(6) :39.
3.	Leibson CL, Tosteson AN, Gabriel SE, et al. Mortality, disability, and nursing home use for persons with and without hip fracture:a population-based study. J Am Geriatr Soc, 2002, 50(10) :1644-1650.
4.	周功, 耿春輝, 劉濤. 動力髖螺釘治療股骨轉子間骨折35例分析. 中華全科醫學, 2011, 9(1) :27, 76.
5.	Vekris MD, Lykissas MG, Manoudis G, et al. Proximal screws placement in intertrochanteric fractures treated with external fixation:comparison of two different techniques. J Orthop Surg Res, 2011, 6:48.
6.	顧立強. 股骨近端骨折的分類與功能評價. 中華創傷骨科雜志, 2004, 6(5) :558-563.
7.	姜保國, 王滿宜. 關節周圍骨折. 北京:人民衛生出版社, 2013:537-538.
8.	James ET, Hunter GA. The treatment of intertrochanteric fractures-a review article. Injury, 1983, 14(5) :421-431.
9.	SCOTT IH. Treatment of intertrochanteric fractures by skeletal pinning and external fixation. Clin Orthop Relat Res, 1957, 10:326-334.
10.	Alcivar E. A new method of external fixation for proximal fractures of the femur. Injury, 2001, 32 Suppl 4:SD107-114.
11.	Buckley JR, Caiach SM. External fixation in comminuted upper femoral fractures. Injury, 1993, 24(7) :476-478.
12.	Lorich DG. External fixation of select intertrochanteric fractures with single hip screw. Clin Orthop Relat Res, 2002, (395) :268.
13.	Dahl A, Varghese M, Bhasin VB. External fixation of intertrochanteric fractures of the femur. J Bone Joint Surg (Br), 1991, 73(6) :955-958.
14.	王明千, 馬長生, 王愛菊, 等. 單邊外固定架治療骨盆骨折并轉子間骨折臨床觀察. 中醫正骨, 2007, 19(10) :795-796.
15.	李敬, 陳巨坤, 周凱, 等. 改良擴孔器逆向擴孔DHS內固定術在老年股骨粗隆間骨折的應用. 中國骨傷, 2011, 24(5) :362-365.
16.	Power J, Doube M, van Bezooijen RL, et al. Osteocyte recruitment declines as the osteon fills in:interacting effects of osteocytic sclerostin and previous hip fracture on the size of cortical canals in the femoral neck. Bone, 2012, 50(5) :1107-1114.
17.	唐克, 段雄波. 動力髖螺釘、Gamma釘、外固定架3種固定物治療老年股骨轉子間骨折. 中國組織工程研究與臨床康復, 2010, 14(52) :9845-9848.
18.	Karn NK, Singh GK, Kumar P, et al. Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal. J Bone Joint Surg (Br), 2006, 88(10) :1347-1350.
19.	Ali AM, Abdelkhalek M, El-Ganiney A. External fixation of intertrochanteric fractures in elderly high-risk patients. Acta Orthop Belg, 2009, 75(6) :748-753.
20.	Moroni A, Faldini C, Pegreffi F, et al. Dynamic hip screw compared with external fixation for treatment of osteoporotic pertrochanteric fractures. J Bone Joint Surg (Am), 2005, 87(4) :753-759.
21.	徐海濤, 王洪光, 鐘聲. 外固定器結合高壓氧治療老年股骨粗隆間骨折. 中國矯形外科雜志, 2004, 12(8) :637-638.
22.	黃夢全, 余斌, 林春秀, 等. 有限元法分析后內側骨折對近端股骨的力學影響. 中國矯形外科雜志, 2010, 18(4) :294-296.
23.	Xu YZ, Geng DC, Mao HQ, et al. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res, 2010, 38(4) :1266-1275.

1. Forte ML, Virnig BA, Kane RL, et al. Geographic variation in device use for intertrochanteric hip fractures. J Bone Joint Surg (Am), 2008, 90(4) :691-699.
2. 徐紀慶, 張霆, 侯寶興. 股骨粗隆間骨折治療方法的臨床分析. 中國中醫骨傷科雜志, 2000, 8(6) :39.
3. Leibson CL, Tosteson AN, Gabriel SE, et al. Mortality, disability, and nursing home use for persons with and without hip fracture:a population-based study. J Am Geriatr Soc, 2002, 50(10) :1644-1650.
4. 周功, 耿春輝, 劉濤. 動力髖螺釘治療股骨轉子間骨折35例分析. 中華全科醫學, 2011, 9(1) :27, 76.
5. Vekris MD, Lykissas MG, Manoudis G, et al. Proximal screws placement in intertrochanteric fractures treated with external fixation:comparison of two different techniques. J Orthop Surg Res, 2011, 6:48.
6. 顧立強. 股骨近端骨折的分類與功能評價. 中華創傷骨科雜志, 2004, 6(5) :558-563.
7. 姜保國, 王滿宜. 關節周圍骨折. 北京:人民衛生出版社, 2013:537-538.
8. James ET, Hunter GA. The treatment of intertrochanteric fractures-a review article. Injury, 1983, 14(5) :421-431.
9. SCOTT IH. Treatment of intertrochanteric fractures by skeletal pinning and external fixation. Clin Orthop Relat Res, 1957, 10:326-334.
10. Alcivar E. A new method of external fixation for proximal fractures of the femur. Injury, 2001, 32 Suppl 4:SD107-114.
11. Buckley JR, Caiach SM. External fixation in comminuted upper femoral fractures. Injury, 1993, 24(7) :476-478.
12. Lorich DG. External fixation of select intertrochanteric fractures with single hip screw. Clin Orthop Relat Res, 2002, (395) :268.
13. Dahl A, Varghese M, Bhasin VB. External fixation of intertrochanteric fractures of the femur. J Bone Joint Surg (Br), 1991, 73(6) :955-958.
14. 王明千, 馬長生, 王愛菊, 等. 單邊外固定架治療骨盆骨折并轉子間骨折臨床觀察. 中醫正骨, 2007, 19(10) :795-796.
15. 李敬, 陳巨坤, 周凱, 等. 改良擴孔器逆向擴孔DHS內固定術在老年股骨粗隆間骨折的應用. 中國骨傷, 2011, 24(5) :362-365.
16. Power J, Doube M, van Bezooijen RL, et al. Osteocyte recruitment declines as the osteon fills in:interacting effects of osteocytic sclerostin and previous hip fracture on the size of cortical canals in the femoral neck. Bone, 2012, 50(5) :1107-1114.
17. 唐克, 段雄波. 動力髖螺釘、Gamma釘、外固定架3種固定物治療老年股骨轉子間骨折. 中國組織工程研究與臨床康復, 2010, 14(52) :9845-9848.
18. Karn NK, Singh GK, Kumar P, et al. Comparison between external fixation and sliding hip screw in the management of trochanteric fracture of the femur in Nepal. J Bone Joint Surg (Br), 2006, 88(10) :1347-1350.
19. Ali AM, Abdelkhalek M, El-Ganiney A. External fixation of intertrochanteric fractures in elderly high-risk patients. Acta Orthop Belg, 2009, 75(6) :748-753.
20. Moroni A, Faldini C, Pegreffi F, et al. Dynamic hip screw compared with external fixation for treatment of osteoporotic pertrochanteric fractures. J Bone Joint Surg (Am), 2005, 87(4) :753-759.
21. 徐海濤, 王洪光, 鐘聲. 外固定器結合高壓氧治療老年股骨粗隆間骨折. 中國矯形外科雜志, 2004, 12(8) :637-638.
22. 黃夢全, 余斌, 林春秀, 等. 有限元法分析后內側骨折對近端股骨的力學影響. 中國矯形外科雜志, 2010, 18(4) :294-296.
23. Xu YZ, Geng DC, Mao HQ, et al. A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res, 2010, 38(4) :1266-1275.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL OBSERVATION OF Othofix PERTROCHANTERIC FIXATOR FOR FIXATION OF INTERTROCHANTERIC FRACTURE

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