No abstract

The aim of this study was to compare the usage of two devices, the twin screw derotation type and the helical blade type, in intertrochanteric fractures in the geriatric population at a tertiary-level center. MethodsForty-six eligible patients with intertrochanteric fractures operated with the standard proximal femoral nail (PFN) or proximal femoral nail anti-rotation (PFNA2) were included for analysis. This was a retrospective analysis of prospectively collected data over the study period. Demographics, various operative parameters, outcome parameters, and complications were assessed. Medical management of osteoporosis was provided to all patients. The student t-test and chi-square test were used with SPSS V22.0 (IBM Corp., Armonk, NY) for statistical analysis. ResultsThe mean follow-up was 14 months. The hospital stay and Harris hip score were similar in both groups, but the radiation exposure, surgical time, and blood loss were significantly less in the case of PFNA2. Screw cutout was also not observed in our study. ConclusionBoth PFNA2 and PFN are effective in treating unstable trochanteric fractures in terms of functional outcomes. However, PFNA2 is better because it requires less radiation exposure (p<0.05) due to single guidewire use, a short learning curve, less blood loss, shorter surgical time(p<0.05), and fewer complications. We suggest it to be the preferred implant in trochanteric fractures in the geriatric population and other age groups.

Resumo Objetivo Avaliar o papel do tropismo facetário (TF) no prolapso discal intervertebral. Métodos Um total de 98 pacientes com dor lombar foram incluídos no estudo. Exames de ressonância magnética foram realizados e analisados, e os ângulos das facetas direita e esquerda foram medidos na seção axial. Os pacientes sem prolapso discal nos níveis L3-L4, L4-L5 e L5-S1 atuam como controles para aqueles com prolapso nos mesmos níveis. Fez-se também uma análise estatística. Resultados A incidência de TF no nível L3-L4 foi de 85,2% em pacientes com hérnia discal (n = 27), e de 56,3% no grupo controle, o que foi estatisticamente significativo (p = 0,008). Da mesma forma, a incidência de TF no nível L4-L5 entre casos e controles foi de 71,4% (n = 35) e 52,4%, respectivamente (p = 0,066). No nível L5-S1, a incidência foi de 66% e 51% nos caso e nos controles, respectivamente (p = 0,13). Conclusão Encontramos associação positiva entre TF e hérnia de disco no nível L3-L4, mas nenhuma associação nos níveis L4-L5 e L5-S1.