Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;49(3):3000605211003766.
doi: 10.1177/03000605211003766.

Benefit of lag screw placement by a single- or two-screw nailing system in elderly patients with AO/OTA 31-A2 trochanteric fractures

Fulong Zhao  1 , Lijuan Guo  2 , Xuefei Wang  1 , Yakui Zhang  1
Affiliations

Benefit of lag screw placement by a single- or two-screw nailing system in elderly patients with AO/OTA 31-A2 trochanteric fractures

Fulong Zhao et al. J Int Med Res. 2021 Mar.

Abstract

Objective: To retrospectively analyze the clinical outcomes of two intramedullary fixation devices, the INTERTAN nail and Gamma3 nail, for treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients.

Methods: In total, 165 elderly patients underwent treatment for AO/OTA 31-A2 trochanteric fractures in our hospital from June 2017 to June 2018 (INTERTAN group, n = 79; Gamma3 group, n = 86). All patients underwent radiological and clinical investigations and were followed up for an average of 12 months. Age, sex, fracture type, surgical time, intraoperative blood loss, fracture healing time, and complications were compared between the two groups.

Results: The surgical time was significantly shorter and the intraoperative blood loss volume was significantly lower in the Gamma3 than INTERTAN group (58.2 ± 2.5 vs. 81.7 ± 14.2 minutes and 170 ± 29 vs. 220 ± 16 mL, respectively). However, there were no significant differences in the reduction quality, hospital stay, fracture healing time, Harris hip score, postoperative complications, or 1-year postoperative mortality.

Conclusion: Both INTERTAN and Gamma3 nails may be effective for surgical treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients. However, the Gamma3 nail was superior to the INTERTAN nail in terms of surgical time and intraoperative blood loss.

Keywords: AO/OTA 31-A2; Gamma3; INTERTAN; Trochanteric fracture; intramedullary nail; outcome.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flow diagram demonstrating the treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients using either the INTERTAN nail or Gamma3 nail.
Figure 2.
Figure 2.
(a, b) Anteroposterior and lateral X-ray views of a 79-year-old man with an intertrochanteric fracture (AO/OTA 31-A2) of the right hip. (c, d) Postoperative anteroposterior and lateral X-ray views of the same patient 12 months after Gamma3 nail fixation of the intertrochanteric fracture of the right hip.
Figure 3.
Figure 3.
(a, b) Anteroposterior and lateral X-ray views of an 81-year-old woman with an intertrochanteric fracture (AO/OTA 31-A2) of the left hip. (c, d) Postoperative anteroposterior and lateral X-ray views of the same patient 12 months after INTERTAN nail fixation of the intertrochanteric fracture of the left hip.
See this image and copyright information in PMC

References

    1. Kesmezacar H, Oğüt T, Bilgili MG, et al.. Treatment of intertrochanteric femur fractures in elderly patients: internal fixation or hemiarthroplasty. Acta Orthop Traumatol Turc 2005; 39: 287–294. - PubMed
    1. Van De Ree CL, Gosens T, Van Der Veen AH, et al.. Development and validation of the Brabant Hip Fracture Score for 30-day and 1-year mortality. Hip Int 2019: 1120700019836962. - PubMed
    1. Su H, Liu H, Liu J, et al.. Elderly patients with intertrochanteric fractures after intramedullary fixation: analysis of risk factors for calf muscular vein thrombosis. Orthopade 2018; 47: 341–346. - PubMed
    1. Kesmezacar H, Ayhan E, Unlu MC, et al.. Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma 2010; 68: 153–158. - PubMed
    1. Higashikawa T, Shigemoto K, Goshima K, et al.. Mortality and the risk factors in elderly female patients with femoral neck and trochanteric fractures. J Clin Med Res 2020; 12: 668–673. - PMC - PubMed

LinkOut - more resources