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.	徐纪庆, 张霆, 侯宝兴. 股骨粗隆间骨折治疗方法的临床分析. 中国中医骨伤科杂志, 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, 耿春辉, 刘涛. 动力髋螺钉治疗股骨转子间骨折35例分析. 中华全科医学, 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.	顾立强. 股骨近端骨折的分类与功能评价. 中华创伤骨科杂志, 2004, 6(5) :558-563.
7.	姜保国, 王满宜. 关节周围骨折. 北京:人民卫生出版社, 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, 马长生, 王爱菊, 等. 单边外固定架治疗骨盆骨折并转子间骨折临床观察. 中医正骨, 2007, 19(10) :795-796.
15.	李敬, 陈巨坤, 周凯, 等. 改良扩孔器逆向扩孔DHS内固定术在老年股骨粗隆间骨折的应用. 中国骨伤, 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. 动力髋螺钉、Gamma钉、外固定架3种固定物治疗老年股骨转子间骨折. 中国组织工程研究与临床康复, 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.	徐海涛, 王洪光, 钟声. 外固定器结合高压氧治疗老年股骨粗隆间骨折. 中国矫形外科杂志, 2004, 12(8) :637-638.
22.	黄梦全, 余斌, 林春秀, 等. 有限元法分析后内侧骨折对近端股骨的力学影响. 中国矫形外科杂志, 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. 徐纪庆, 张霆, 侯宝兴. 股骨粗隆间骨折治疗方法的临床分析. 中国中医骨伤科杂志, 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, 耿春辉, 刘涛. 动力髋螺钉治疗股骨转子间骨折35例分析. 中华全科医学, 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. 顾立强. 股骨近端骨折的分类与功能评价. 中华创伤骨科杂志, 2004, 6(5) :558-563.
7. 姜保国, 王满宜. 关节周围骨折. 北京:人民卫生出版社, 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, 马长生, 王爱菊, 等. 单边外固定架治疗骨盆骨折并转子间骨折临床观察. 中医正骨, 2007, 19(10) :795-796.
15. 李敬, 陈巨坤, 周凯, 等. 改良扩孔器逆向扩孔DHS内固定术在老年股骨粗隆间骨折的应用. 中国骨伤, 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. 动力髋螺钉、Gamma钉、外固定架3种固定物治疗老年股骨转子间骨折. 中国组织工程研究与临床康复, 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. 徐海涛, 王洪光, 钟声. 外固定器结合高压氧治疗老年股骨粗隆间骨折. 中国矫形外科杂志, 2004, 12(8) :637-638.
22. 黄梦全, 余斌, 林春秀, 等. 有限元法分析后内侧骨折对近端股骨的力学影响. 中国矫形外科杂志, 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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