Medial cortical reduction does not influence outcomes in geriatric intertrochanteric femur fractures treated with proximal femoral nail  

作　　者：Prabu Mounisamy Hanoop Suresh Sushma Chandrashekar Udayakumar D Naveen Jeyaraman Madhan Jeyaraman Sathish Muthu 

机构地区：[1]Department of Orthopaedics,Jawaharlal Institute of Postgraduate Medical Education and Research,Puducherry 605006,India [2]Department of Orthopaedics,Sri Manakula Vinayagar Medical College and Hospital,Puducherry 605107,India [3]Department of Orthopaedics,ACS Medical College and Hospital,Dr MGR Educational and Research Institute,Chennai 600077,Tamil Nadu,India [4]Department of Orthopaedics,Orthopaedic Research Group,Coimbatore 641045,Tamil Nadu,India [5]Central Research Laboratory,Meenakshi Medical College Hospital and Research Institute,Meenakshi Academy of Higher Education and Research,Chennai 600078,Tamil Nadu,India

出　　处：《World Journal of Orthopedics》2025年第4期43-50,共8页世界骨科杂志(英文)

摘　　要：BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.

关 键 词：Intertrochanteric femur fracture Cephalomedullary nail Proximal femoral nail Medial cortex Varus collapse 

分 类 号：R687.3[医药卫生—骨科学]