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The Results of Proximal Femoral Nail for Intertrochanteric Fracture in Hemodialysis Patient.

 Kyung Sub Song  ;  Sang Phil Yoon  ;  Su Keon Lee  ;  Seung Hwan Lee  ;  Bong Seok Yang  ;  Byeong Mun Park  ;  Ick Hwan Yang  ;  Beom Seok Lee  ;  Ji Ung Yeom 
 Hip & Pelvis, Vol.29(1) : 54-61, 2017 
Journal Title
 Hip & Pelvis 
Issue Date
Femur ; Internal fixation ; Intertrochanteric fracture ; Proximal femoral nail ; Renal dialysis
PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30). The medical history and clinical findings including preoperative and postoperative blood examinations, radiological examinations and ambulatory status (measured using the Koval score). The rate of complications and morbidities were also investigated and compared. RESULTS: Preoperative hemoglobin/hematocrit was lower but a significant increase in partial thromboplastin time was observed in the hemodialysis group. The amount of bleeding/transfusions were higher and operative time was longer in the hemodialysis group. Upon radiologic examination, there was no significant difference in rate of unstable fracture and nonunion between the two groups. However the postoperative Koval score was significantly worse and the odds ratio of inability to walk after surgery was 13.5 times higher in the hemodialysis group. CONCLUSION: There was no significant difference in radiological results, but the risk of inability to walk after surgery was 13.5 times higher in the hemodialysis group. Hemodialysis patients have more morbidities and are hemodynamically unstable therefore require special attention. Accurate reduction and firm fixation is required and attentive postoperative rehabilitation is needed.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Ick Hwan(양익환)
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