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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Long versus short cephalomedullary nail for trochanteric femur fractures (OTA 31-A1, A2 and A3): a systematic review
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Long versus short cephalomedullary nail for trochanteric femur fractures (OTA 31-A1, A2 and A3): a systematic review

机译：长短头髓髓钉治疗股骨粗隆骨骨折（OTA 31-A1，A2和A3）：系统评价

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class="Heading">Background id="Par1" class="Para">Both long and short cephalomedullary nails (CMN) may be used to treat trochanteric femur fractures. The objective of this paper was to compare the clinical outcomes between long and short CMN in the treatment of trochanteric hip fractures. class="Heading">Materials and methods id="Par2" class="Para">A literature search was performed, identifying 135 papers; 4 of which met inclusion and exclusion criteria. Papers included were those that compared cohorts of long and short nails for stable trochanteric femur fractures of level III evidence or superior. Data was pooled and analyzed, focusing on reoperation rate, secondary femoral shaft fracture rate, estimated blood loss, transfusion rate, operative time and length of stay. class="Heading">Results id="Par3" class="Para">Included in the analysis were 1276 patients, with 438 short and 838 long CMN. The average age was 82.0?years for short CMN and 79.0?years for long CMN (P?=?0.0002). The average follow up was 18?months, 46?% were male, and 71?% had an ASA (American Society of Anesthesiologists score) classification?≥3. The rate of reoperation was 5.0?% and 3.8?% for short and long CMN, respectively (P?=?0.31). The rate of refracture was 1.6?% and 0.95?% for short and long CMN, respectively (P?=?0.41). As compared to long nails, short nails had an average blood loss of 39?mL less (P?=?0.0003), an 8.8?% decrease in transfusion rate (P?=?0.07), and incurred 19?min less operative time (P??0.0001). No significant differences between short and long nails were observed for either other complications, hardware complications, non-union, or mortality. class="Heading">Conclusions id="Par4" class="Para">For trochanteric femur fractures, short CMN have a low reoperation rate while significantly decreasing operative time and estimated blood loss with the additional benefit of being cost effective. class="Heading">Level of evidence id="Par05" class="Para">Level 3.
机译：class =“ Heading”>背景 id =“ Par1” class =“ Para”>长头和短头颅髓内钉（CMN）均可用于治疗股骨转子粗隆骨折。本文的目的是比较长和短CMN在股骨转子骨骨折中的临床疗效。 class =“ Heading”>材料和方法 id =“ Par2”进行了文献检索，发现135篇论文;其中4个符合纳入和排除标准。包括比较长钉和短钉组比较稳定的股骨转子粗隆骨折III级或更高水平的论文。汇总并分析数据，重点是再手术率，继发性股骨干骨折率，估计的失血量，输血率，手术时间和住院时间。 class =“ Heading”>结果 id =“ Par3” class =“ Para”>分析包括1276名患者，其中438例短而838例长。短CMN的平均年龄为82.0岁，长CMN的平均年龄为79.0岁（ P ？=？0.0002）。平均随访18个月，男性占46％，ASA（美国麻醉医师学会评分）≥3级占71％。短期和长期CMN的再手术率分别为5.0％和3.8％（ P ？=？0.31）。短期和长期CMN的折光率分别为1.6％和0.95％（ P ？=？0.41）。与长指甲相比，短指甲的平均失血量减少了39？mL（ P ？=？0.0003），输血率降低了8.8？％（ P ？=？0.07），并且减少了19分钟的手术时间（ P ？<？0.0001）。在其他并发症，硬体并发症，不愈合或死亡率方面，长指甲和短指甲之间没有显着差异。 class =“ Heading”>结论 id =“ Par4”类=“ Para”>对于股骨转子粗骨骨折，短CMN的再手术率较低，同时显着减少了手术时间并估计失血量，且具有成本效益。 class =“ Heading”>证据水平 id =“ Par05” class =“ Para”>第3级。

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