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首页> 外文期刊>Open Journal of Urology >An Assessment of the Relationship between Nonunion and Device Failure Following the Treatment of Intertrochanteric Fracture, by Dynamic Hip Screw (DHS) Using Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association (AO/OTA) and Dorr Classification
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An Assessment of the Relationship between Nonunion and Device Failure Following the Treatment of Intertrochanteric Fracture, by Dynamic Hip Screw (DHS) Using Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association (AO/OTA) and Dorr Classification

机译：动态髋螺钉（DHS）使用骨合成/骨伤科协会（AO / OTA）进行的动态髋螺钉（DHS）和Dorr分类评估股骨转子间骨折后骨不连与装置失败之间的关系

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Background: Intertrochanteric fractures are of intense interest globally. They are the most frequently operated fracture type, have the highest postoperative fatality rate of surgically treated fractures, and have become a serious health resource issue due to the high cost of care required after injury. A number of problems exist when determining the best option for treatment for intertrochanteric fractures. The classification systems do not work well enough for preoperative planning and the reduction criteria have not been well defined. Methods: All patients who presented to Firoozgar Hospital, Tehran with intertrochanteric fracture, between March 20th 2013 and December 21st 2015, underwent DHS implementation, after 6-month follow-up period. Demographic data, preoperative radiographic fracture, bone quality typing (AO/OTA and Dorr classification), American Society of Anesthesiologists (ASA) score and evaluation of their correlation with the complication of fixation including nonunion and device failure were recorded and analyzed. Result: 101 patients including 54 males (53.5%) and 47 females (46.5%) underwent DHS implementation. Mean population age was 73.06 ± 16.36 years with an age range of 30 to 94 years; the most frequent age period was 76 - 85 years, injured by low-energy trauma mechanism and 23.8% patients were injured in a high-energy trauma. 56 patients completed the 6-month follow-up evaluation which ranged from 1 to 80 weeks. According to AO/OTA classification, the most common type among the patient population was A2, 27 patients (51.5%); while the most common group from Dorr classification turned to be group B (39.6%). Classification by ASA score revealed Class II to be most frequent among the patient population (56.4%). Nonunion was seen in eight of patients (14.3%). Three patients (5.4%) had device failure, two cases showed side plate breakage, and another one had screw cut out. There was no significant relationship between AO/OTA classification with the both complications i.e. the development of device failure (P = 0.85) and nonunion (P = 0.99). Non-significant correlation was found between Dorr classification with device failure (P = 0.06) and nonunion (P = 0.11). Conclusion: Regarding recent studies, more effective factor on the outcome is patient’s medical condition before surgery compared to the radiographic findings including AO/OTA and Dorr classification.
机译：背景：转子间骨折在全球引起广泛关注。它们是最常操作的骨折类型，手术治疗的骨折术后死亡率最高，并且由于受伤后需要高昂的护理费用而成为严重的健康资源问题。在确定治疗转子间骨折的最佳选择时，存在许多问题。分类系统不能很好地用于术前计划，并且降低标准尚未明确定义。方法：2013年3月20日至2015年12月21日在德黑兰Firoozgar医院就诊的所有股骨转子间骨折患者均经过6个月的随访，均接受了DHS治疗。记录并分析了人口统计学数据，术前放射学上的骨折，骨质量分型（AO / OTA和Dorr分类），美国麻醉医师学会（ASA）评分以及它们与包括骨不连和器械失败在内的固定并发症的相关性评估。结果：101例患者接受了DHS手术，包括54例男性（53.5％）和47例女性（46.5％）。平均人口年龄为73.06±16.36岁，年龄范围为30至94岁;最常见的年龄段为76-85岁，受低能创伤机制伤害，高能创伤使23.8％的患者受伤。 56名患者完成了为期1到80周的6个月随访评估。根据AO / OTA分类，在患者人群中最常见的类型是A2，27例（51.5％）。而从Dorr分类中最常见的组变成了B组（39.6％）。通过ASA评分分类显示II类在患者人群中最为频繁（56.4％）。八名患者（14.3％）出现骨不连。 3例（5.4％）的患者出现设备故障，2例显示侧板断裂，另一例切除了螺钉。 AO / OTA分类与两种并发症（即设备故障的发展（P = 0.85）和骨不连（P = 0.99）之间没有显着关系。在设备故障的Dorr分类（P = 0.06）和骨不连结（P = 0.11）之间发现无显着相关性。结论：关于最近的研究，与包括AO / OTA和Dorr分类在内的影像学发现相比，对结局更有效的因素是患者术前的医疗状况。

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