The Effect of Subchondral Claw-Deploying Lag Screw on Lateral Sliding Distance and Cut-Out in Treating Intertrochanteric Fractures

Yıl 2024, , 32 - 37, 29.02.2024

Levent Horoz , Mehmet Cakmak

https://doi.org/10.54005/geneltip.1331906

Öz

Introduction: The incidence of intertrochanteric fractures has increased in recent years due to the growing elderly population at risk of hip fractures, primarily attributed to osteoporosis. Among hip fractures, the prevalence of intertrochanteric fractures is progressively rising.
Aim: To evaluate clinical and radiological results of the lag screw that deploys the claw in the subchondral area of the femoral head in the treatment of advanced age unstable intertrochanteric fractures.
Methods: We retrospectively reviewed patients with intertrochanteric fractures treated with proximal femoral nails between 2019 and 2021. A total of 107 patients were examined under two groups according to the choice of the nail (Interclaw lag screw(n=52), Proximal femoral nail anti-rotation (n=55) used in the treatment. The radiological parameters in the post-operative 1st-day radiographs of the patients were evaluated. The changes in the first month, three, six months, and one-year control radiographs of the patients were evaluated. Changes in tip apex distance and lateral sliding of the lag screw were compared between the two groups.
Result: There was no statistically significant difference between the two groups regarding operation time, post-operative femoral neck/shaft angle, post-operative Calcar gap (mm), and tip-apex distance (TAD) (mm). In the last clinical follow-up, the two groups had a statistically significant difference in the femoral neck/shaft angle and TAD change. There was a significant difference in sliding distance between the two groups at the last follow-up.
Conclusion: Using a subchondral claw-deploying lag screw is a reliable implant choice in the surgical treatment of geriatric intertrochanteric fractures. The claw mechanism increases fixation strength and restricts the movements of the lag screw in the femoral head.

Anahtar Kelimeler

İntertrochanteric fracture, Proximal femoral nailing, Lag screw sliding, lag screw

İntertrokanterik Kırıkların Tedavisinde Subkondral Pençe Yerleştirme Gecikmeli Vidanın Yanal Kayma Mesafesine ve Kesmeye Etkisi

Öz

Giriş: İntertrokanterik kırıkların insidansı, özellikle osteoporoza atfedilen kalça kırığı riski taşıyan yaşlı nüfusun artması nedeniyle son yıllarda artmıştır. Kalça kırıkları arasında intertrokanterik kırıkların prevalansı giderek artmaktadır.
Amaç: İleri yaş instabil intertrokanterik kırıkların tedavisinde, femur başında subkondral pence açan lag vidanın klinik ve radyolojik sonuçlarını değerlendirmek.
Metod: 2019-2021 yılları arasında proximal femur çivisi ile tedavi edilen intertrokanterik kırıklı hastaları retrospektif olarak inceledik. Toplam 107 hasta çivi seçimine göre iki grup altında incelendi (Interclaw lag screw(n=52), Proksimal femoral çivi anti-rotasyon (n=55) Hastaların post-operatif 1. gün radyografileri değerlendirildi. Hastaların 1, 3, 6 ay ve 1. yıl kontrol grafilerindeki değişiklikler değerlendirildi. Lag vidasının uç apeks mesafesindeki değişiklikler ve lag vidasının yanal kayması iki grup arasında karşılaştırıldı.
Bulgular: Ameliyat süresi, ameliyat sonrası femur boyun/şaft açısı, ameliyat sonrası Kalkar açıklığı (mm) ve vida uç-tepe mesafesi (VUTM) (mm) açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu. Son klinik takipte femur boyun/şaft açısı ve VUTM değişikliği açısından iki grup arasında istatistiksel olarak anlamlı bir fark bulundu. Son takipte iki grup arasında yanal kayma mesafesinde anlamlı bir fark gözlemlendi.
Sonuç: İleri yaş intertrokanterik kırıklı hastaların cerrahi tedavisinde subkondral pençe açılan lag vidası kullanımı güvenilirdir. Pençe mekanizması, lag vidasının tespit gücünü arttırmakta femur başı içindeki hareketlerini kısıtlamaktadır.

Anahtar Kelimeler

İntertrokanterik kırık, Proksimal femur çivileme, lag vidası kayması, çektirme vidası

Destekleyen Kurum

yok

Kaynakça

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