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The treatment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail

DC Field Value Language
dc.contributor.author박희완-
dc.contributor.author양규현-
dc.date.accessioned2015-05-19T17:04:54Z-
dc.date.available2015-05-19T17:04:54Z-
dc.date.issued2008-
dc.identifier.issn0022-5282-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/107474-
dc.description.abstractBACKGROUND: Reverse obliquity intertrochanteric fractures have been recognized as having unique anatomic and mechanical characteristics. Even though some clinical reports regarding intramedullary hip nailing for reverse obliquity intertrochanteric fracture show favorable results, there has been no clinical report of intramedullary hip nailing regarding the clinical significance of the lesser trochanteric fragment which differentiates Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A3.3 from A3.1 and A3.2. METHODS: We retrospectively reviewed the clinical results of 46 cases of reverse obliquity or transverse intertrochanteric fracture treated with intramedullary hip nails. Twenty-five fractures were fixed with proximal femoral nail (PFN), and 21 fractures were fixed with intertrochanteric subtrochanteric nail. RESULTS: Among 40 patients, followed up for more than 6 months, 22 31-A3.3 fractures (84.6%) out of 26 and all 14 A3.1 or A3.2 fractures were healed after the first operation. The complications were four cases of fixation failure and one case of femoral shaft fracture after fall. They occurred in the A3.3 type fracture, which were fixed with the PFN. The mean union time was longer in the A3.3 group (5.98 months, range 3-17 months) compared with that in the A3.1 or A3.2 group (4.65 months, range 3-9 months) (p = 0.048). Two cases of reciprocal migration of two screws (Z-effect) required exchange of the femoral neck screw to a shorter one in the PFN group. The amount of sliding of the femoral neck screw of the PFN (6.8 mm, range 0.3 mm-16.5 mm) was greater than that of the intertrochanteric subtrochanteric nail lag screw (1.89 mm, range: 0.2 mm-4.6 mm) (p = 0.012). Statistical analysis showed that the type of implant PFN, fracture subtype (31-A3.3), and old ages (more than 65 years old) significantly prolonged the union time (p < 0.05). CONCLUSION: The lesser trochanteric fragment and posteromedial defect in 31-A3.3 fracture seems to play an important role in the stability after intramedullary hip nailing. The causes of fixation failure in the PFN group were associated with excessive sliding of femoral neck screw, which was aggravated by toggling motion in the 31-A3.3 fractures.-
dc.description.statementOfResponsibilityopen-
dc.format.extent852~857-
dc.relation.isPartOfJournal of Trauma-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAccidental Falls-
dc.subject.MESHAccidents, Traffic-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHBone Nails*-
dc.subject.MESHCohort Studies-
dc.subject.MESHFemale-
dc.subject.MESHFracture Fixation, Intramedullary/adverse effects-
dc.subject.MESHFracture Fixation, Intramedullary/methods*-
dc.subject.MESHFracture Healing/physiology-
dc.subject.MESHHip Fractures/diagnostic imaging*-
dc.subject.MESHHip Fractures/pathology-
dc.subject.MESHHip Fractures/surgery*-
dc.subject.MESHHumans-
dc.subject.MESHInjury Severity Score-
dc.subject.MESHLeg Length Inequality/prevention & control-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPain Measurement-
dc.subject.MESHPostoperative Complications/diagnostic imaging-
dc.subject.MESHPostoperative Complications/epidemiology-
dc.subject.MESHProbability-
dc.subject.MESHPrognosis-
dc.subject.MESHRadiography-
dc.subject.MESHRange of Motion, Articular/physiology*-
dc.subject.MESHRecovery of Function-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment-
dc.subject.MESHStatistics, Nonparametric-
dc.titleThe treatment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Orthopedic Surgery (정형외과학)-
dc.contributor.googleauthorSi Yong Park-
dc.contributor.googleauthorKyu Hyun Yang-
dc.contributor.googleauthorJe Huyn Yoo-
dc.contributor.googleauthorHan Kook Yoon-
dc.contributor.googleauthorHui Wan Park-
dc.identifier.doi18849802-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01777-
dc.contributor.localIdA02282-
dc.relation.journalcodeJ01916-
dc.identifier.pmid18849802-
dc.identifier.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005373-200810000-00019&LSLINK=80&D=ovft-
dc.subject.keywordFemur-
dc.subject.keywordReverse obliquity intertrochanteric fracture-
dc.subject.keywordIntramedullary hip nail-
dc.contributor.alternativeNamePark, Hui Wan-
dc.contributor.alternativeNameYang, Kyu Hyun-
dc.contributor.affiliatedAuthorPark, Hui Wan-
dc.contributor.affiliatedAuthorYang, Kyu Hyun-
dc.rights.accessRightsnot free-
dc.citation.volume65-
dc.citation.number4-
dc.citation.startPage852-
dc.citation.endPage857-
dc.identifier.bibliographicCitationJournal of Trauma, Vol.65(4) : 852-857, 2008-
dc.identifier.rimsid56890-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers

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