Zapleti pri žebljanju pertrohanternih zlomov z IMHS žebljem
Complications after nailing of the pertrochanteric fractures with IMHS nail

slovenian

2006

volume 75, issue 5

Bone Nails   Bone Screws   Fracture Fixation   Hip Fractures   Treatment Outcome

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Intramedullary hip nails, which combine the advantages of intramedullary fixation with those of a sliding screw, should diminish the incidence of complications after osteosynthesis of the pertrochanteric fractures. Despite less mechanical failures, this has not happened. However, some new specific complications have occured. In this retrospective study of the pertrochantericfractures treated with IMHS nail, the author is analysing the importance of experience and the impact of learning curve on incidence of complications. Between March 1996 and July Z999 65 patients with 65 non pathologic pertrochanteric fractures were operated with IMHS nail. Thirty-one were operated in 1996/97 (Group 1), thirty four later on (Group II). Between the groups there were no differences in demographic characteristics, types of fractures, used material or outcome. Twelve out of 65 patients (eight from Group 1, four from Group II) had at least one complication. In five patients there was a crack of femoral diaphisis. In two reduction of the fracture was insufficient. In another two the hip screw protruded into the joint One fracture dislocated secondarely. Three patients had infection. One non-union of the femoral neck showed after removal of the nail 2.5 years postinjury. Stratified statistical analysis showed that Group l had signifficantly more mechanical complications (insufficient reduction, hip screw protrusion, secondary dislocation), whereas differences between the groups in jemur cracks, infection and non-union were insignificant. This comparative study hasshown frequent complications after nailing of the pertrochanteric fracturesand that with growing experience the incidence of complications decreases. All this points to an important learning curve .

10.04.2014