RESUMO
In unstable pertrochanteric fractures, there are still debates regarding the complications and long-term benefits after internal fixation using short or long cephalomedullary nails. Therefore, a study was developed regarding this idea. From May 2017 to April 2020, 61 patients with unstable (AO 31-A2) and intertrochanteric fractures (AO 31-A3) were surgically operated on. During follow-up, 8 patients were excluded (lost or deceased). A total of 26 patients received internal short nail system fixation and 27 received a long nail system. All cases followed the standard 6-week rehabilitation protocol. Follow-up was at 3, 6 weeks, 3, 6 and 12 months, and clinical and functional assessment were determined by a different surgeon using the Visual Analogue Scale (VAS), Harris Hip Score (HHS) and Functional Ambulation Categories (FAC). A total of 42 (79.2%) had a 31.A2 fracture (21 in the long nail group and 21 in the short nail group) and 11 (20.8%) had a 31.A3 fracture (6 in long nail group and 5 in the short nail group). Surgical time was significantly longer (P<0.05) in the long nail group (an average of 81.38±12.01 min), compared with the short nail group (53.11±8.36 min). Blood loss was significantly higher (P<0.05) in the long nail group (210±12.1 ml) compared to the short nail group (75.4±14.8 ml). No statistical differences were noted regarding tip-apex distance (TAD) and VAS score. At 6 months, HHS was better for the short nail group (84.76±3.68) (P<0.05). Regarding the FAC scale, no significant statistical differences were identified. Cut-out occurred in 2 cases in the short nail group and 1 case from the long nail group. Only 1 peri-implant fracture occurred in a patient with a long cephalomedullary nail. In conclusion, the long cephalomedullary nail requires a longer surgical time and is associated with an increase in intraoperative blood loss without improving the functional outcome after 12 months postoperatively. A larger sample of cases is required to thoroughly analyze the postoperative complications.
RESUMO
The shock is a general, non-specific pathological process, caused by the sudden action of very brutal pathogens, a situation for which the body has no reserves for qualitative and quantitative compensation-adaptation. The objective of our experiment was to make an evaluation of the changes in some hematological and biochemical parameters of the blood, during some hypovolemic evolutions, in the rabbits. Twenty New Zealand White rabbits we used. An IDEXX ProCyte Dx Hematology Analyzer was applied to perform hematological determinations. An IDEXX VetTest Chemistry Analyzer was used to perform blood biochemistry determinations. The data obtained were statistically analyzed, calculating the Media and Standard Deviation (SD), using the Microsoft Excel application. At the same time, the statistical significance of the differences between the batches was calculated based on the t test (Student) using the Microsoft Excel application. The study revealed a decrease in the number of red blood cells and leukocytes per unit volume of blood (p⟨0.05) in the case of group 2 and an increase in glucose, triglycerides (p⟨0.05). Experimental hypovolemia induced in the conditions of our experiment determined: an obvious posthemorrhagic anemia, a significant leukopenia mainly 6 hours after the production of hypovolemic shock and a significant hyperglycemia, manifested mainly 12 hours after the induction of hypovolemia.
