Relationship between body position and reduction in cephalomedullary nailing for femoral in-tertrochanteric fractures / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the relationship between body position and fracture reduction in cephalomedullary nailing for femoral intertrochanteric fractures. Methods Included in this analysis were 368 femoral intertrochanteric fractures undergoing cephalomedullary nailing from January 2010 to De-cember 2015. They were 191 men and 177 women, aged from 42 to 102 years ( average, 73. 1 ± 11. 0 years ) . By AO classification, there were 105 cases of type 31-A1, 131 ones of 31-A2, and 132 ones of type 31-A3. Supine position A ( contralateral hip and knee flexed at 90 degrees ) was applied in 99 cases, supine position B ( contralateral limb supine straight and abduction ) in 178 cases, and lateral position in 91 cases. The 3 groups were compared in terms of reduction quality, fluoroscopy time, fluoroscopy frequency, operative time, and Harris hp score at 6 months after operation. Results Reduction quality supine position A group ( 97. 8％) > supine position B group ( 87. 9％) > lateral position group ( 72. 5％) . Fluoroscopy time lat-eral position group ( 34. 4 ± 5. 8 min ) > supine position A group ( 29. 4 ± 6. 4 min ) > supine position B group ( 27. 1 ± 5. 2 min ) . Fluoroscopy frequency lateral position group ( 15. 5 ± 5. 0 times ) > supine posi-tion A group ( 14. 0 ± 3. 4 times ) > supine position B group ( 11. 2 ± 2. 9 times ) . The above differences were significant between any 2 groups ( P <0. 05 ) . Operation time lateral position group ( 59. 0 ± 10. 7 min ) >supine position A group ( 58. 4 ± 11. 2 min ) > supine position B group ( 51. 2 ± 8. 7 min ) . There were sig-nificant differences between supine position B group and either of the other 2 groups ( P < 0. 05 ) . There were no significant differences among the 3 groups in the Harris hp score at 6 months after operation ( P >0. 05 ) . Conclusion In cephalomedullary nailing for patients with femoral intertrochanteric fracture, the position of contralateral limb supine straight and abduction can benefit fracture reduction, affect anteroposterior and lateral fluoroscopy the least, provide convenience for surgical maneuver and thus shorten surgical time.