Trokanterik femur kırıklarında lateral dekübit pozisyonu ve traksiyon masasının intramedüller çivilemeye etkisinin karşılaştırılması

Abstract

Purpose: The objective of this study is to evaluate the influence of patient positioning on intraoperative outcomes, specifically intraoperative time, fracture reduction, and implant location, in individuals with trochanteric femur fractures undergoing intramedullary nailing. The study compares two patient positions: the lateral decubitus position (LDP group) and the utilization of a traction table (TT group).
 Materials and Methods: A total of 82 patients with trochanteric femur fractures, who underwent surgery were included. The patients were divided into LDP and TT groups. Various parameters, including age, gender, fracture details, setup time, operation time, anesthesia time, fluoroscopy time, tip-apex distance (TAD), collodiaphyseal angle (CDA), reduction quality, and implant position, were analyzed.
 Result: Surgical time in the LD group was 33.90 ± 6.05 minutes, whereas in the TT group, it was 33.00 ± 6.64 minutes. Anesthesia time was 50.55 ± 7.46 minutes in the LD group and 55.26 ± 12.49 minutes in the TT group. Fluoroscopy time in the LD group was 45.20 ± 7.18 seconds, while in the TT group, it was 46.23 ± 4.50 seconds. Lateral decubitus position resulted in shorter setup and anesthesia times compared to the traction table. 
 Conclusion: Intramedullary nailing in the lateral decubitus position is a viable and practical choice for fracture reduction, with the potential to decrease morbidity and mortality rates especially in elderly patients.