The long and short of cephalomedullary nails in the treatment of osteoporotic pertrochanteric fracture.
- Author:
Choon Chiet HONG
1
;
Nazrul NASHI
1
;
Milindu Chanaka MAKANDURA
1
;
Jiong Hao Jonathan TAN
1
;
Luke PETER
1
;
Diarmuid MURPHY
1
Author Information
- Publication Type:Journal Article
- Keywords: cephalomedullary nails; complications; osteoporosis; pertrochanteric fracture; short versus long nail
- MeSH: Aged; Aged, 80 and over; Bone Nails; Female; Femoral Fractures; surgery; Fracture Fixation, Intramedullary; instrumentation; Hip Fractures; surgery; Humans; Incidence; Length of Stay; Male; Middle Aged; Osteoporotic Fractures; surgery; Postoperative Complications; Reoperation; Retrospective Studies; Treatment Outcome
- From:Singapore medical journal 2017;58(2):85-91
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONPertrochanteric fractures after low-energy trauma are common among osteoporotic patients. Although the use of intramedullary devices to treat such fractures is becoming increasingly popular, there is a paucity of data comparing the outcomes of the use of short cephalomedullary nails (SCN) with the use of long cephalomedullary nails (LCN). This study aimed to compare the outcomes of treatment using LCN with treatment using SCN for patients with osteoporotic pertrochanteric fractures.
METHODSA retrospective review of 64 patients with osteoporotic pertrochanteric fractures who were treated with either LCN or SCN and had a minimum follow-up of one year was performed. Primary outcome measures include complications, revision surgeries and union rates. Secondary outcome measures include duration of surgery, estimated blood loss, length of hospital stay, and ambulatory and mortality status at one year.
RESULTSThere was no significant difference in the clinical and functional outcomes of the patients who were treated with LCN and those who were treated with SCN. However, there was a higher incidence of heterotopic ossification in the latter group, and a slightly greater average estimated blood loss and duration of surgery in the former group. Patients treated with LCN tended to be more osteoporotic.
CONCLUSIONOur study found no significant difference in terms of complications, revision surgeries, union rates and ambulatory status between the patients who were treated with LCN and those who were treated with SCN. Both LCN and SCN provided safe and reliable outcomes in the treatment of osteoporotic pertrochanteric fractures.