Intramedullary nailing for irreducible spiral subtrochanteric fractures:A comparison of cerclage and non-cerclage wiring  

作　　者：Yan-Hui Guo Zhan-Lin Song Hua-Yong Zheng Jie Gao Yi-Yun Lin Zhi Liu Lian-Hua Li 

机构地区：[1]Department of Orthopedics,The Seventh Medical Center of Chinese People's Liberation Army General Hospital,Beijing,100048,China [2]Department of Orthopedics,The Fourth Medical Center of Chinese People's Liberation Army General Hospital,Beijing,100048,China

出　　处：《Chinese Journal of Traumatology》2024年第5期305-310,共6页中华创伤杂志（英文版）

摘　　要：Purpose:Intramedullary nailing is the preferred internal fixation technique for the treatment of subtrochanteric fractures because of its biomechanical advantages.However,no definitive conclusion has been reached regarding whether combined cable cerclage is required during intramedullary nailing treatment.This study is performed to compare the clinical effects of intramedullary nailing with cerclage and non-cerclage wiring in the treatment of irreducible spiral subtrochanteric fractures.Methods:Patients with subtrochanteric fractures admitted to our center from January 2013 to December 2021 were retrospectively analyzed.The patients were enrolled in the case-control study according to the inclusion and exclusion criteria and divided into the non-cerclage group and the cerclage group.The patients'clinical data,including the operative time,intraoperative blood loss,hospital stay,reoperation rate,fracture union time,and Harris hip score,were compared between these 2 groups.Categorical variables were compared using Chi-square or Fisher's exact test.Continuous variables with normal distribution were presented as mean±standard deviation and analyzed with Student's t-test.Nonnormally distributed variables were expressed as median(Q_(1),Q_(3))and assessed using the Mann-Whitney test.A p<0.05 was considered significant.Results:In total,69 patients were included in the study(35 patients in the non-cerclage group and 34 patients in the cerclage group).The baseline data of the 2 groups were comparable.There were no significant difference in the length of hospital stay(z=-0.391,p=0.696),operative time(z=-1.289,p=0.197),or intraoperative blood loss(z=-1.321,p=0.186).However,compared with non-cerclage group,the fracture union time was shorter(z=-5.587,p<0.001),the rate of nonunion was lower(χ^(2)=6.030,p=0.03),the anatomical reduction rate was higher(χ^(2)=5.449,p=0.03),and the Harris hip score was higher(z=-2.99,p=0.003)in the cerclage group,all with statistically significant differences.Conclusions:Intramedullary nailing c

关 键 词：Hip fracture Subtrochanteric fracture Intramedullary nail Cerclage wiring 

分 类 号：R687.3[医药卫生—骨科学]