Femurs, nails and fractures
The present retrospective cohort study by Israeli orthopedic surgeons assessed the incidence of proximal femoral shortening (PFS) when intertrochanteric fractures were treated with a cephalomedullary nail (CMN). In addition, the authors analyzed the effects of PFS on patient outcomes.
48 consecutive patients with OTA/AO 31-A intertrochanteric fractures were treated with a Gamma CMN. PFS was assessed for abductor lever arm (x vector), femoral height (y vector), and overall shortening (z vector) on anteroposterior radiographs; subsequently, the authors noted fixation success and retained ambulatory capacity.
- 18, 20, and 29 patients experienced shortening of >5 mm of the x, y, and z vectors, respectively.
- Shortening of >10 mm of the x, y, and z vectors was measured in 5, 6, and 8 patients, respectively.
- Mean shortening of the x, y, and z vectors was 4.5, 5.5, and 7 mm, respectively.
- Greater PFS was independently associated with fixation failure and inability to retain ambulatory capacity (P ≤ 0.05 and P ≤ 0.025, respectively).
- NB: an unstable fracture pattern was not associated with greater PFS.
The authors’ summary: PFS commonly occurs after CMN of intertrochanteric fractures with a Gamma CMN, and greater PFS seems to be associated with fixation failure and inability to retain ambulatory capacity postoperatively.
Source: Gilat, R. et al.: "Proximal Femoral Shortening After Cephalomedullary Nail Insertion for Intertrochanteric Fractures", Journal of Orthopaedic Trauma. 31(6):311–315, JUN 2017, DOI: 10.1097/BOT.0000000000000835.
Eine randomisierte doppelblinde Studie zeigte die nicht Nicht-Unterlegenheit einer neuen Lipidformulierung von niedrigdosiertem Ibuprofen vs. Standard-Ibuprofen in doppelt so hoher Dosierung,......