Advances in orthopedics · 2025
Clinical Outcome of the Oblique Locking Hip Screw.
СтатьяНазвание и аннотация: Перевод в очереди
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Nakagawa Shota, Toyonaga Masato, Sawaguchi Takeshi, Matsushita Takashi
Аннотация
PURPOSE: To evaluate the clinical outcomes and effectiveness of the newly developed Oblique Locking Hip Screw (OLHS) compared with those of the commonly used cephalomedullary nail (CMN) in trochanteric femoral fracture treatment in older patients.
METHODS: This was a single-center retrospective study of patients with trochanteric fractures. Overall, 129 patients were analyzed: 64 treated with OLHS and 65 with CMN. Patient demographic data, fracture classification, surgical parameters (e.g., operating time and intraoperative blood loss), and clinical outcomes were assessed. Postoperative outcomes were evaluated using radiographic findings and statistical analyses, including Fisher's exact test and the Mann-Whitney U test.
RESULTS: The study included 57 patients in both the OLHS and CMN groups with 3 months of radiographic follow-up data. OLHS was more commonly used for stable AO A1 fractures, whereas CMN was preferred for unstable A2 fractures. Postoperative telescoping was greater with OLHS than with CMN (4.8 ± 4.3 vs. 3.0 ± 4.7 mm; p = 0.0028; mean difference 1.8 mm, 95% CI 0.15-3.45). Mortality, union, and adverse events were similar; two CMN patients had nonunion, with one conversion to total hip arthroplasty.
CONCLUSION: OLHS provides satisfactory clinical outcomes for trochanteric fractures in this exploratory study, with preliminary evidence of adequate stability. Further randomized controlled trials or matched comparative studies are warranted to confirm these findings.
METHODS: This was a single-center retrospective study of patients with trochanteric fractures. Overall, 129 patients were analyzed: 64 treated with OLHS and 65 with CMN. Patient demographic data, fracture classification, surgical parameters (e.g., operating time and intraoperative blood loss), and clinical outcomes were assessed. Postoperative outcomes were evaluated using radiographic findings and statistical analyses, including Fisher's exact test and the Mann-Whitney U test.
RESULTS: The study included 57 patients in both the OLHS and CMN groups with 3 months of radiographic follow-up data. OLHS was more commonly used for stable AO A1 fractures, whereas CMN was preferred for unstable A2 fractures. Postoperative telescoping was greater with OLHS than with CMN (4.8 ± 4.3 vs. 3.0 ± 4.7 mm; p = 0.0028; mean difference 1.8 mm, 95% CI 0.15-3.45). Mortality, union, and adverse events were similar; two CMN patients had nonunion, with one conversion to total hip arthroplasty.
CONCLUSION: OLHS provides satisfactory clinical outcomes for trochanteric fractures in this exploratory study, with preliminary evidence of adequate stability. Further randomized controlled trials or matched comparative studies are warranted to confirm these findings.