Description of new “epsilon sign” and its significance in reduction in highly unstable variant of intertrochanteric fracture

Chandak, Rajendra; Malewar, Nikhil; Jangle, Ajit; Agarwal, Rahul; Sharma, Mohit; Kekatpure, Aditya

doi:10.1007/s00590-019-02478-4

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…The wide variation in the use of these implants suggests that other factors besides their clinical efficacy determine their use. Most studies have focused on radiographic evidence of failure and resurgery outcomes without considering the patient's recovery of joint function (20)(21)(22)(23)(24), and most have involved the first generation of intramedullary devices in which design modifications of the latest generation of nails have partially corrected earlier design flaws, with periimplant and prosthesis fractures now being relatively rare complications (25)(26)(27)(28). From an economic point of view, the implantation cost of intramedullary nailing should be considered, as treating patients with intertrochanteric fractures can increase costs by three-to five-fold (29,30).…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the effect of intramedullary fixation and extramedullary fixation on unstable intertrochanteric fractures

Zhang¹,

Zhang²,

Yang³

2021

Ann Palliat Med

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Background: Intertrochanteric fracture of femur is a common fracture in the elderly, and the number of intramedullary nails used to manage intertrochanteric fractures has steadily increased, but the evidence for the clinical efficacy of this practice is lacking. The present study retrospectively compared the clinical outcomes and imaging features of patients with unstable intertrochanteric hip fractures treated with traditional extramedullary hip screws (AO/OTA 31-A2) and patients with the same injury treated with newer intramedullary screws.Methods: Lower limb measurement (LLM) for the main results of the hip-specific tools, functional independence measure (FIM), and "timed up and go" (TUG) to test the scale and timing of the 2-minute walk test were used as secondary tools for clinical outcomes. Other detailed radiological parameters to evaluate the fracture movement, such as heterotopic ossification, and implant failure, were also recorded.Results: There were no significant differences between the intramedullary and extramedullary treatment groups in terms of the measures acquired by the primary or secondary clinical outcome tools (P>0.05), but the radiographic parameters favored the intramedullary treatment group as it showed reduced femoral neck shortening.Conclusions: Although treatment with intramedullary nailing resulted in better radiographic assessment results, this did not translate into better functional recovery outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical study on the effect of intramedullary fixation and extramedullary fixation on unstable intertrochanteric fractures

Zhang¹,

Zhang²,

Yang³

2021

Ann Palliat Med

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“…Due to the aging of the population and rapid development of society, the number of elderly patients with ITFs is increasing year by year. Open or closed reduction with internal fixation has been accepted as effective treatments for this injury 7 . An ideal surgical technique for elderly ITFs patients should have the least intra and post operative morbidity 8 .…”

Section: Discussionmentioning

confidence: 99%

Bipolar Hemiarthroplasty should not be selected as the primary option for intertrochanteric fractures in elderly patients

Huang

Shi

Pan

et al. 2020

Sci Rep

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intertrochanteric fractures (itfs) in the elderly are still a big challenge for clinical doctors. Although proximal femoral nail antirotation (PFNA) and bipolar hemiarthroplasty (BPH) are selected by most of the orthopaedic surgeons for elderly ITFs patients, there is still no consensus on the superiority of PFNA and BPH for ITFs in elderly. In this study, we hypothesized that BPH should not be selected as the primary option for ITFs in elderly patients, and analyzed clinical data of 202 elderly ITFs patients aged 80 years or more treated with PFNA (Group A) and BPH (Group B) to compare the early outcome of PFNA and BPH for ITFs in elderly patients aged 80 years or more. We found that operation time and blood loss during surgery in group A are less than in Group B. Time of weight bearing after operation in Group A is longer than in Group B. Incidence of complications 2 weeks after operation in Group A is 9.29% less than 25.81% in Group B (χ 2 = 9.539, p = 0.002). Mortality rates 12 months after operation in Group A is 11.43% similar with 19.35% in Group B (χ 2 = 2.261, p = 0.133). Harris Hip Score 12 months after operation in Group A is 68.00 ± 29.11 points similar with 65.73 ± 33.29 points in Group B (t = 0.490, p = 0.625). Therefore, for elderly ITFs patients aged 80 years or more, BPH should not be selected as the primary option for itfs in elderly patients.

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“…Each system has its own advantages and disadvantages [2]. Therefore, we this study comparatively analyzes the clinical e cacy of INTERTAN, γ-III interlocking intramedullary nailing and PFLP in treating femoral intertrochanteric fractures and provides references to improve curative management.…”

Section: Common Extramedullary Xation Systems Include Proximal Femoramentioning

confidence: 99%

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

Zhou¹,

Xia²,

Ma³

et al. 2020

Preprint

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Objective: To compare the clinical efficacy of proximal femoral intramedullary fixation and anatomical locking compression plate in the treatment of femoral intertrochanteric fractures among the elderly. Methods: In this retrospective study, 210 surgically treated patients with intertrochanteric fractures of the femur were analyzed and divided into groups A, B and C according to the surgical approach. Group A had interlocking compression nailing (INTERTAN) done (n=69); group B had γ-III interlocking intramedullary nailing (γ-III) done (n=73); and group C had proximal femoral anatomic locking plate (PFLP) done (n=68). All patients’ data were followed up completely, and their clinical outcomes were observed. Results: Group A and B were found to perform better than group C in operation time, bleeding volume, time of leaving bed, fracture healing time and hospitalization time (P < 0.05). Their respective incidences of postoperative complications were significantly lower than that of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). The Harris scores of groups A and B at 1, 3 and 6 months after operation were significantly higher than those of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). Conclusions: In the treatment of femoral intertrochanteric fractures, intramedullary fixation influences little on blood circulation at the fracture end, accelerates fracture healing, and enhances hip joint function, which assists patients in recovering faster postoperatively. Moreover, it enables them to gain mobility at an early stage and reduces postoperative complications of fractures. Its short-term clinical effects are better than extramedullary fixation, which should be more widely adapted clinically.

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Description of new “epsilon sign” and its significance in reduction in highly unstable variant of intertrochanteric fracture

Cited by 11 publications

References 6 publications

Clinical study on the effect of intramedullary fixation and extramedullary fixation on unstable intertrochanteric fractures

Clinical study on the effect of intramedullary fixation and extramedullary fixation on unstable intertrochanteric fractures

Bipolar Hemiarthroplasty should not be selected as the primary option for intertrochanteric fractures in elderly patients

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

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