Yıl: 2020 Cilt: 31 Sayı: 2 Sayfa Aralığı: 209 - 217 Metin Dili: İngilizce DOI: 10.5606/ehc.2020.72421 İndeks Tarihi: 04-05-2021

A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing

Öz:
Objectives: This study aims to compare the clinical and functional results of intertrochanteric femoral fractures treated with bipolar hemiarthroplasty (BHA) or proximal femoral nailing (PFN) in elderly patients.Patients and methods: This multicenter, prospectively followed-up, retrospectively compared cohort-type study included 308 patients (81 males, 227 females; mean age 78.4±7.2 years; range, 65 to 95 years) who were treated with BHA or PFN for intertrochanteric fractures by five orthopedic surgeons in four provinces and seven clinics between January 2014 and May 2018. Clinical follow-up was performed at third week, third and sixth months, and at the end of the first and second years. The American Society of Anesthesiologists for preoperative status, Singh index for bone quality, and Harris Hip Score (HHS) for functional outcomes were evaluated.Results: While 156 patients (38 males, 118 females; mean age 77.7±5.9) were treated with BHA, 152 patients (43 males, 109 females; mean age 79±6.1) were treated with PFN. While there was no significant difference between the two groups in terms of total HHS, a significant difference was found in the sub-parameters (p<0.001). Good and excellent results were found in 78.2% of BHA and 86.2% of PFN patients. Mortality rates were similar at the end of two years (14% and 13.6%, respectively).Conclusion: In general, clinical and functional outcomes of BHA and PFN are similar. The rates of pulmonary embolism and deep vein thrombosis are significantly higher in BHA. However, BHA is advantageous in terms of operation time and early weight bearing compared to PFN.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Tokgöz MA, Atik OŞ, Esendağlı G, Öğüt B, Bozkurt HH. Is it possible that the pathogenesis of osteoarthritis could start with subchondral trabecular bone loss like osteoporosis? Eklem Hastalik Cerrahisi 2018;29:152-8.
  • 2. Emami M, Manafi A, Hashemi B, Nemati A, Safari S. Comparison of intertrochanteric fracture fixation with dynamic hip screw and bipolar hemiarthroplasty techniques. Arch Bone Jt Surg 2013;1:14-7.
  • 3. Özkayın N, Okçu G, Aktuğlu K. Intertrochanteric femur fractures in the elderly treated with either proximal femur nailing or hemiarthroplasty: A prospective randomised clinical study. Injury 2015;46:S3-8.
  • 4. Paul O, Barker JU, Lane JM, Helfet DL, Lorich DG. Functional and radiographic outcomes of intertrochanteric hip fractures treated with calcar reduction, compression, and trochanteric entry nailing. J Orthop Trauma 2012;26:148-54.
  • 5. Görmeli G, Korkmaz MF, Görmeli CA, Adanaş C, Karataş T, Şimşek SA. Comparison of femur intertrochanteric fracture fixation with hemiarthroplasty and proximal femoral nail systems. Ulus Travma Acil Cerrahi Derg 2015;21:503-8.
  • 6. Hari Prasad S, Siddaram N Patil, Sarath Chandra P, Cecil Fernando A. Functional outcome of unstable intertrochanteric femur fracture in elderly osteoporotic patients treated by primary cemented bipolar hemiarthroplasty versus internal fixation with proximal femoral nailing. International Journal of Orthopaedics Sciences 2017;3:319-23.
  • 7. Kim SY, Kim YG, Hwang JK. Cementless calcar-replacement hemiarthroplasty compared with intramedullary fixation of unstable intertrochanteric fractures. A prospective, randomized study. J Bone Joint Surg Am 2005;87:2186-92.
  • 8. Tomak Y, Kocaoglu M, Piskin A, Yildiz C, Gulman B, Tomak L. Treatment of intertrochanteric fractures in geriatric patients with a modified external fixator. Injury 2005;36:635-43.
  • 9. Jones HW, Johnston P, Parker M. Are short femoral nails superior to the sliding hip screw? A meta-analysis of 24 studies involving 3,279 fractures. Int Orthop 2006;30:69-78.
  • 10. Tang P, Hu F, Shen J, Zhang L, Zhang L. Proximal femoral nail antirotation versus hemiarthroplasty: a study for the treatment of intertrochanteric fractures. Injury 2012;43:876-81.
  • 11. Barton TM, Gleeson R, Topliss C, Greenwood R, Harries WJ, Chesser TJ. A comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur: a prospective randomized trial. J Bone Joint Surg Am 2010;92:792-8.
  • 12. Jiang SD, Jiang LS, Zhao CQ, Dai LY. No advantages of Gamma nail over sliding hip screw in the management of peritrochanteric hip fractures: a meta-analysis of randomized controlled trials. Disabil Rehabil 2008;30:493-7.
  • 13. Bendo JA, Weiner LS, Strauss E, Yang E. Collapse of intertrochanteric hip fractures fixed with sliding screws. Orthop Rev 1994;Suppl:30-7.
  • 14. Broos PL, Rommens PM, Geens VR, Stappaerts KH. Pertrochanteric fractures in the elderly. Is the Belgian VDP prosthesis the best treatment for unstable fractures with severe comminution? Acta Chir Belg 1991;91:242-9.
  • 15. Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R. The proximal femoral nail (PFN)--a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand 2003;74:53-8.
  • 16. Friedl W, Clausen J. Experimental examination for optimized stabilisation of trochanteric femur fractures, intra- or extramedullary implant localisation and influence of femur neck component profile on cut-out risk. Chirurg 2001;72:1344-52.
  • 17. Desteli EE, İmren Y, Erdoğan M, Aydagün Ö. Quality of life following treatment of trochanteric fractures with proximal femoral nail versus cementless bipolar hemiarthroplasty in elderly. Clin Invest Med 2015;38:E63-72.
  • 18. Luo X, He S, Zeng D, Lin L, Li Q. Proximal femoral nail antirotation versus hemiarthroplasty in the treatment of senile intertrochanteric fractures: Case report. Int J Surg Case Rep 2017;38:37-42.
  • 19. Rodop O, Kiral A, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable intertrochanteric fractures. Int Orthop 2002;26:233-7.
APA EKİNCİ Y, Gürbüz K, batın s, Kahraman M, Doğar F, Kaya Erten Z (2020). A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. , 209 - 217. 10.5606/ehc.2020.72421
Chicago EKİNCİ YAKUP,Gürbüz Kaan,batın sabri,Kahraman Murat,Doğar Fatih,Kaya Erten Zeliha A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. (2020): 209 - 217. 10.5606/ehc.2020.72421
MLA EKİNCİ YAKUP,Gürbüz Kaan,batın sabri,Kahraman Murat,Doğar Fatih,Kaya Erten Zeliha A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. , 2020, ss.209 - 217. 10.5606/ehc.2020.72421
AMA EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. . 2020; 209 - 217. 10.5606/ehc.2020.72421
Vancouver EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. . 2020; 209 - 217. 10.5606/ehc.2020.72421
IEEE EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z "A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing." , ss.209 - 217, 2020. 10.5606/ehc.2020.72421
ISNAD EKİNCİ, YAKUP vd. "A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing". (2020), 209-217. https://doi.org/10.5606/ehc.2020.72421
APA EKİNCİ Y, Gürbüz K, batın s, Kahraman M, Doğar F, Kaya Erten Z (2020). A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Joint diseases and related surgery, 31(2), 209 - 217. 10.5606/ehc.2020.72421
Chicago EKİNCİ YAKUP,Gürbüz Kaan,batın sabri,Kahraman Murat,Doğar Fatih,Kaya Erten Zeliha A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Joint diseases and related surgery 31, no.2 (2020): 209 - 217. 10.5606/ehc.2020.72421
MLA EKİNCİ YAKUP,Gürbüz Kaan,batın sabri,Kahraman Murat,Doğar Fatih,Kaya Erten Zeliha A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Joint diseases and related surgery, vol.31, no.2, 2020, ss.209 - 217. 10.5606/ehc.2020.72421
AMA EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Joint diseases and related surgery. 2020; 31(2): 209 - 217. 10.5606/ehc.2020.72421
Vancouver EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing. Joint diseases and related surgery. 2020; 31(2): 209 - 217. 10.5606/ehc.2020.72421
IEEE EKİNCİ Y,Gürbüz K,batın s,Kahraman M,Doğar F,Kaya Erten Z "A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing." Joint diseases and related surgery, 31, ss.209 - 217, 2020. 10.5606/ehc.2020.72421
ISNAD EKİNCİ, YAKUP vd. "A multicenter intertrochanteric fracture study in the elderly: Hemiarthroplasty versus proximal femoral nailing". Joint diseases and related surgery 31/2 (2020), 209-217. https://doi.org/10.5606/ehc.2020.72421