Cephalomedullary nail versus sliding hip screw for unstable intertrochanteric fractures in elderly patients

Journal of Orthopaedic Surgery
Ivan Tjun Huat ChuaErnest Beng Kee Kwek

Abstract

To compare the short-term ambulatory function of elderly patients after fixation of unstable intertrochanteric fractures with either the AO-ASIF proximal femoral nail anti-rotation (PFNA) device or the dynamic hip screw (DHS). 63 patients aged 60 years or older underwent fixation for unstable intertrochanteric fractures (AO types A2 and A3) using the PFNA (n=25) or DHS (n=38). The decision for the type of implant used was based on the lead surgeon's preference, according to perceived fracture stability and clinical experience. In patients having PFNA fixation, weight bearing ambulation and rehabilitation was commenced on day 2. The extent of weight bearing was decided by the lead surgeon based on the stability of the fracture. In patients having DHS fixation, non-weight bearing and ambulation with a walking aid was commenced on day 2. Ambulatory function before injury and after surgery was measured using the Parker Mobility Score (PMS). The 2 groups were compared in terms of the PMS, ambulatory independence, and environmental mobility. Respectively in PFNA and DHS patients, 32% and 13% (p=0.035) were ambulant with a walking frame at discharge; the remainder were wheelchair bound. Patients treated with PFNA had significantly hig...Continue Reading

References

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Sep 19, 2003·Archives of Orthopaedic and Trauma Surgery·F FogagnoloC A J Paccola
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Sep 19, 2009·The Journal of International Medical Research·J ZouH Yang

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Citations

Nov 14, 2019·Journal of Orthopaedic Surgery and Research·Martin F HoffmannClifford B Jones
Apr 25, 2015·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Brian C WernerSeth R Yarboro
Jul 11, 2019·Journal of Orthopaedic Trauma·Kenneth A EgolSanjit Konda
Apr 9, 2020·Archives of Orthopaedic and Trauma Surgery·Michael YamE B K Kwek
Aug 26, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Sorawut ThamyongkitErik A Hasenboehler
Mar 9, 2018·The Journal of International Medical Research·Chi ZhangXinchao Zhang

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