PROXIMAL FEMORAL NAILING VERSUS DYNAMIC HIP SCREW IN MANAGEMENT OF STABLE INTERTROCHANTERIC FEMUR FRACTURES: A COMPARISON OF CLINICAL AND RADIOLOGICAL OUTCOMES

Tuna PEHLİVANOĞLU; Serkan BAYRAM; Mehmet DEMİREL; Mehmet CHODZA; Emre KOCAZEYBEK; Ahmet SALDUZ; Turgut AKGÜL; Önder YAZICIOĞLU

Article Details

PROXIMAL FEMORAL NAILING VERSUS DYNAMIC HIP SCREW IN MANAGEMENT OF STABLE INTERTROCHANTERIC FEMUR FRACTURES: A COMPARISON OF CLINICAL AND RADIOLOGICAL OUTCOMES

Authors:

Tuna PEHLİVANOĞLU | Serkan BAYRAM | Mehmet DEMİREL | Mehmet CHODZA | Emre KOCAZEYBEK | Ahmet SALDUZ | Turgut AKGÜL | Önder YAZICIOĞLU

Publisher:

Istanbul University

Main Topics:

Promotion of health

Journal:

Journal of Istanbul Faculty of Medicine 2021 Vol.84 Issue 4, pp.514-520

Document Type:

Article

Publication Date:

9/2021

Document Language:

English

Document ID (Org No.):

2000515412

Frequency:

Quarterly

eISSN:

1305-6441

Abstract:

 

Objective: The aim of this study was to compare the cost-effectivity, clinical and radiological outcomes of the proximal femoral nail (PFN) and Dynamic hip screw (DHS) in the management of stable intertrochanteric femur fractures (SIFFs). Material and Methods: Patients who underwent surgical treatment for a SIFF in our department were retrospectively identified and then divided into two groups according to the treatment modality: Group 1, 57 patients (36 female, 21 male; mean age = 74.5±9.9 years) treated with PFN and Group 2, 65 patients (34 female, 31 male; 72±10.2 years) treated with DHS. Primary outcome measures were: estimated blood loss (EBL), total operating time (TOT), duration of hospital stay (DHS), rate of postoperative complication, rate of mortality, and treatment cost. Radiographic assessment included anteroposterior/lateral tip-apex distance (TAD) and amount of limb length discrepancy (LLD). Results: No significant differences were observed in demographic characteristics between the two treatment groups (p>0.05). The mean follow-up was 44.2±31 months in group 1 and 53.7±38 months in group 2 (p=0.077). The mean TOT and EBL were significantly shorter in group PFN than in group DHS (p0.05). The post-operative complication rate was 9.5% in group PFN and 8.3% in group DHS, with no significant difference (p=0.83). There were significant differences in neither TAD nor LLD between the two treatment groups (p=0.69 and p=0.87, respectively). Conclusion: The two treatment modalities seem to have similar effect to maintain stability for patients with stable IFFs. However, less EBL and shorter operation time can be expected from PFN compared to DHS in such patients.

 


Amaç: Bu çalışmanın amacı, stabil intertrokanterik femur kırıklarının (SIFF) tedavisinde proksimal femur çivisi (PFN) ve dinamik kalça vidasının (DHS) maliyet-etkililik, klinik ve radyolojik sonuçlarını karşılaştırmaktı. Gereç ve Yöntemler: SIFF nedeniyle cerrahi tedavi uygulanan hastalar geriye dönük olarak belirlendi ve tedavi şekline göre iki gruba ayrıldı: Grup 1, 57 hasta (36 kadın, 21 erkek; ortalama yaş = 74,5±9,9 yıl) PFN ile tedavi edilen ve Grup 2, DHS ile tedavi edilen 65 hasta (34 kadın, 31 erkek; 72±10,2 yıl). Birincil sonuç ölçütleri; tahmini kan kaybı (EBL), toplam ameliyat süresi (TOT), hastanede kalış süresi (DHS), ameliyat sonrası komplikasyon oranı, ölüm oranı ve tedavi maliyeti olarak yapıldı. Radyografik değerlendirme, ön-arka/yan uç-apeks mesafesini (TAD) ve uzuv uzunluk uyumsuzluğu miktarını (LLD) karşılaştırıldı. Bulgular: İki tedavi grubu arasında demografik özelliklerde anlamlı bir farklılık gözlenmedi (p>0,05). Ortalama takip süresi grup 1’de 44,2±31 ay ve grup 2’de 53,7±38 ay idi (p=0,077). Ortalama TOT ve EBL, grup PFN’de grup DHS’ye göre anlamlı olarak daha kısaydı (p0.05). Ameliyat sonrası komplikasyon oranı grup PFN’de %9,5 ve grup DHS’de %8,3 idi ve anlamlı bir fark yoktu (p=0,83). İki tedavi grubu arasında ne TAD ne de LLD’de anlamlı farklılıklar yoktu (sırasıyla p=0,69 ve p=0,87). Sonuç: İki tedavi modalitesi, stabil IFF’leri olan hastalarda stabiliteyi sürdürmek için benzer etkiye sahip görünmektedir. Ancak bu tür hastalarda DHS’ye kıyasla PFN’den daha az EBL ve daha kısa operasyon süresi beklenebilir.

.

Article Details

PROXIMAL FEMORAL NAILING VERSUS DYNAMIC HIP SCREW IN MANAGEMENT OF STABLE INTERTROCHANTERIC FEMUR FRACTURES: A COMPARISON OF CLINICAL AND RADIOLOGICAL OUTCOMES

Authors: Tuna PEHLİVANOĞLU | Serkan BAYRAM | Mehmet DEMİREL | Mehmet CHODZA | Emre KOCAZEYBEK | Ahmet SALDUZ | Turgut AKGÜL | Önder YAZICIOĞLU

Publisher: Istanbul University

Main Topics: Promotion of health

Journal: Journal of Istanbul Faculty of Medicine 2021 Vol.84 Issue 4, pp.514-520

Document Type: Article

Publication Date: 9/2021

Document Language: English

Document ID (Org No.): 2000515412

Frequency: Quarterly

eISSN: 1305-6441

Issues

Authors:

Tuna PEHLİVANOĞLU | Serkan BAYRAM | Mehmet DEMİREL | Mehmet CHODZA | Emre KOCAZEYBEK | Ahmet SALDUZ | Turgut AKGÜL | Önder YAZICIOĞLU

Publisher:

Istanbul University

Main Topics:

Promotion of health

Journal:

Journal of Istanbul Faculty of Medicine 2021 Vol.84 Issue 4, pp.514-520

Document Type:

Article

Publication Date:

9/2021

Document Language:

English

Document ID (Org No.):

2000515412

Frequency:

Quarterly

eISSN:

1305-6441