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Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails

机译:卧位侧卧位用头颅髓内钉治疗股骨转子周围骨折

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ABSTRACTOBJECTIVE: To perform a retrospective radiographic evaluation on the fracture reduction and implant position in the femoral head among patients with pertrochanteric fractures who had been treated using a cephalomedullary nail in lateral decubitus; and to assess factors that might interfere with the quality of the fracture reduction and with the implant position in using this technique. METHODS: Nineteen patients with a diagnosis of pertrochanteric fractures of the femur who had been treated using cephalomedullary nails in lateral decubitus were evaluated. For outpatient radiographic evaluations, we used the anteroposterior view of the pelvis and lateral view of the side affected. We measured the cervicodiaphyseal angle, tip-apex distance (TAD), spatial position of the cephalic element in relation to the head, and the bispinal diameter. To make an anthropometric assessment, we used the body mass index. Two groups of patients were created: one in which all the criteria were normal (TAD ≤25 mm, cervicodiaphyseal angle between 130° and 135° and cephalic implant position in the femoral head in the central-central quadrant); and another group presenting alterations in some of the criteria for best prognosis. RESULTS: Female patients predominated (57.9%) and the mean age was 60 years. Seven patients presented a central-central cephalic implant position. One patient present a cervicodiaphyseal angle 135° and the maximum TAD was 32 mm; consequently, 12 patients presented some altered criteria (63.2%). None of the characteristics evaluated differed between the patients with all their criteria normal and those with some altered criteria, or showed any statistically significant association among them ( p 0.05). CONCLUSION: The technique described here enabled good reduction and good positioning of the implant, independent of the anthropometric indices and type of fracture.
机译:摘要:目的:回顾性分析经头颅外侧卧位使用头颅髓内钉治疗的股骨转子周围骨折患者股骨头的骨折复位和植入位置。并评估可能影响使用该技术的骨折复位质量和植入物位置的因素。方法:评估了19例诊断为股骨转子周围骨折的患者,他们在外侧卧位使用头颅髓内钉治疗。对于门诊影像学评估,我们使用骨盆的前后视图和患侧的侧视图。我们测量了颈椎干s角,顶尖距离(TAD),相对于头部的头颅元件的空间位置以及双脊椎直径。为了进行人体测量,我们使用了体重指数。将患者分为两组:一组符合所有标准(TAD≤25 mm,颈dia骨夹角在130°至135°之间,并且头中部在股骨头位于中中象限);另一组则对某些最佳预后标准进行了改变。结果:女性患者占主导地位(57.9%),平均年龄为60岁。 7例患者出现了中央-中央头颅植入物位置。一名患者的颈椎干angle角> 135°,最大TAD为32 mm;因此,有12名患者提出了一些改变的标准(63.2%)。在所有标准正常的患者和标准有所改变的患者之间,所评估的特征均无差异,或在他们之间显示出统计学上的显着相关性(p> 0.05)。结论:此处描述的技术能够实现植入物的良好复位和良好定位,而与人体测量指标和骨折类型无关。

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