Journal of orthopaedic trauma · 2023
Geriatric Intertrochanteric Fractures: What Is the Optimal Follow-Up Period?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Green John, Watson John Tracy, Shaheen Philip, Kuldjanov Djoldas
Аннотация
OBJECTIVE: Evaluate patients with intertrochanteric fractures who were treated operatively to determine optimal follow-up to ensure complete fracture healing and recognize complications.
DESIGN: Retrospective review.
SETTING: Academic Level 1 trauma center.
PATIENTS/PARTICIPANTS: Inclusion criteria included isolated intertroch fractures (not pathologic) and complete radiographic and clinical data, with at least 1-year follow-up. Four hundred ninety-seven patients were identified. Two hundred forty-nine patients met inclusion criteria with 194 patients studied.
INTERVENTION: Operative fixation with either CMN or SHS.
MAIN OUTCOME MEASUREMENTS: Radiographic parameters included time to union, neck-shaft angle, tip apex distance, and femoral neck screw telescoping (shortening) for both CMS and SHS combined. Postoperative complications were recorded.
RESULTS: Union was achieved at a mean of 64.8 ± 30.7 days. Mortality (n = 12), infection (n = 4), and implant failure (n = 5) occurred within 3 months. Neck-shaft angle was changed before 3 months. Significant neck shortening for both CMN and SHS occurred within 6 weeks ( P =<0.001). Major complications occurred early, within 3 months.
CONCLUSIONS: Most fractures healed by 3 months and the remainder by 6 months. Routine follow-up for 6 months is more than sufficient for most of these fractures.
LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
DESIGN: Retrospective review.
SETTING: Academic Level 1 trauma center.
PATIENTS/PARTICIPANTS: Inclusion criteria included isolated intertroch fractures (not pathologic) and complete radiographic and clinical data, with at least 1-year follow-up. Four hundred ninety-seven patients were identified. Two hundred forty-nine patients met inclusion criteria with 194 patients studied.
INTERVENTION: Operative fixation with either CMN or SHS.
MAIN OUTCOME MEASUREMENTS: Radiographic parameters included time to union, neck-shaft angle, tip apex distance, and femoral neck screw telescoping (shortening) for both CMS and SHS combined. Postoperative complications were recorded.
RESULTS: Union was achieved at a mean of 64.8 ± 30.7 days. Mortality (n = 12), infection (n = 4), and implant failure (n = 5) occurred within 3 months. Neck-shaft angle was changed before 3 months. Significant neck shortening for both CMN and SHS occurred within 6 weeks ( P =<0.001). Major complications occurred early, within 3 months.
CONCLUSIONS: Most fractures healed by 3 months and the remainder by 6 months. Routine follow-up for 6 months is more than sufficient for most of these fractures.
LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.