J Korean Orthop Assoc.  2015 Feb;50(1):8-17. 10.4055/jkoa.2015.50.1.8.

Is Distal Locking Constantly Necessary When Intertrochanteric Femur Fracture Is Stably Fixed in the Distal Area with Intramedullary Hip Nail?

Affiliations
  • 1Department of Orthopedic Surgery, VHS Medical Center, Seoul, Korea. 3188yun@naver.com

Abstract

PURPOSE
The purpose of this study is to investigate the constant necessity of distal locking when intertrochanteric fracture was treated with an intramedullary hip nail.
MATERIALS AND METHODS
From April 2010 to June 2013, 47 stable intertrochanteric fractures (AO/OTA 31-A1) were treated with second generation intramedullary hip nailing. They were followed-up for more than 12 months. In the first group of 18 cases distal locking was used, and in the second group of 29 cases, distal locking was not used. We compared the radiologic and clinical results of the two groups.
RESULTS
Comparison of the two groups of patients showed no difference in terms of radiological and functional results. Postoperative thigh pain developed in eight cases (17%). A statistically difference was observed between isthmic diameter and used nail diameter (Fisher exact test, p=0.01) for postoperative thigh pain. In logistic regression analysis, the difference between isthmic diameter and used nail diameter was the most statistically significant factor in development of postoperative thigh pain (p=0.04, odd ratio=27.75).
CONCLUSION
Our results suggested that the second generation intramedullary hip nail may be successfully implanted without distal interlocking in 31-A1 intertrochanteric femur fracture when the reduction status was satisfactory and stable fixation of the distal area was estimated by less than 3 mm difference between isthmic diameter and used nail diameter.

Keyword

femur; intertrochanteric fractures; intramedullary hip nail; distal locking

MeSH Terms

Femur*
Hip Fractures
Hip*
Humans
Logistic Models
Thigh
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