Hip Pelvis.  2016 Dec;28(4):225-231. 10.5371/hp.2016.28.4.225.

Surgical Results of the Cephalomedullary Nail for the Femoral Intertrochanteric Fracture: Comparison between Non-experienced Surgeons and Experienced Surgeon

• Seo JS
• Min HJ
• Kim DM
• Oh SM
• Kim SM

• KMID: 2364700
• DOI: http://doi.org/10.5371/hp.2016.28.4.225

Abstract

PURPOSE
Cephalomedullary nail (CM nail) in the treatment of femoral intertrochanteric fractures is in the lime light in recent years. The purpose of this study is to compare surgical outcomes between experienced surgeon and non-experienced surgeons in respect of CM nail for femoral intertrochanteric fractures.
MATERIALS AND METHODS
The 129 patients underwent CM nail for femoral intertrochanteric fracture more than six months of follow-up from April 2011 to March 2014 in Seoul Medical Center (Seoul, Korea) were participated in this study. For this study, group A consisted of experienced surgeons who performed more than 500 times of CM nail, and group B consisted of non-experienced surgeons who performed less than 50 times of CM nail. Clinical and radiologic outcomes, complications and the need for reoperation between both groups were compared in the study.
RESULTS
According to clinical result, both the mean operation time and transfusion volume were significantly longer and greater in group B (P<0.05). In the radiologic outcomes, adequacy of reduction, tip-apex distance and numbers of case placed in the Cleveland zones 5, 6 and 8; there was no statistical difference between both groups. Moreover, rate of complication and reoperation had same results as radiologic outcomes.
CONCLUSION
There was no significant difference with statistical data in complications from CM nail for femoral intertrochanteric fractures between experienced surgeon and non-experienced surgeon. Although the operation time and transfusion volume were significantly longer and greater in the case of operation by non-experienced surgeon, satisfactory performance was seen in the complications and the need for reoperation.

Keyword

Femur; Intertrochanteric fractures; Cephalomedullary nail

MeSH Terms

Femur
Follow-Up Studies
Hip Fractures
Humans
Reoperation
Seoul
Surgeons*

Figure

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  Fig. 1 (A-C) Initial radiographs of a 75-year-old women shows unstable fracture (Evans type V; 31A2.2 AO/OTA), fixed with Gamma 3 nail (B and C) by experienced surgeon. Immediate postoperative anteroposter and translateral views.

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  Fig. 2 (A-C) Initial radiographs of a 74-year-old man shows unstable fracture (Evans type V; 31A2.2 AO/OTA), fixed with Gamma 3 nail (B and C) by non-experienced surgeon. Immediate postoperative anteroposter and translateral views.

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