Single screw type of lag screw results higher reoperation rate in the osteosynthesis of basicervical hip fracture |
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| Institution: | 1. Ajou University Hospital, Department of Orthopaedic Surgery, 164, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, South Korea;2. Chung-Ang University, College of Medicine, Department of Orthopaedic Surgery, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea;3. Yeungnam University Medical Center, Department of Orthopedic Surgery, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, South Korea;4. Gyeongsang National University Hospital, Department of Orthopaedic Surgery, 79, Gangnam-ro, Jinju, Gyeongsangnam-do, 52727, South Korea;5. Konkuk University Medical Center, Department of Orthopaedic Surgery, School of Medicine, Konkuk University, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea;1. Department of Plastic Surgery, Chiba Rosai Hospital, Ichihara, Japan;2. Department of Plastic Surgery, Wound Repair and Regeneration, Fukuoka University, School of Medicine, Fukuoka, Japan;3. Department of Diagnostic and Interventional Radiology, Osaka University, Graduate School of Medicine, Suita, Japan;4. Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Japan;5. Department of Plastic and Reconstructive Surgery, Shinshu University, School of Medicine, Matsumoto, Japan;6. Center for Vascular Anomalies, KKR Sapporo Medical Center Tonan Hospital, Sapporo, Japan;1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachidori 1-757, Chuo-ku, Niigata-shi 951-8510, Japan;2. Department of Orthopedic Surgery, Tsuruoka Municipal Shonai Hospital, Izumimachi 4-20, Tsuruoka-shi 997-8515, Japan;3. Department of Orthopedic Surgery, Niigata Prefectural Shibata Hospital, Honcho 1-2-8, Shibata-shi 957-8588, Japan;4. Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, Shinkocho 1-18, Chuo-ku, Niigata-shi 950-8556, Japan;5. Department of Orthopedic Surgery, Nagaoka Chuo General Hospital, Kawasakimachi 2041, Nagaoka-shi 940-8653, Japan;6. Department of Orthopedic Surgery, Niigata Rosai Hospital, Touncho 1-7-12, Joetsu-shi 942-8502, Japan;7. Department of Orthopedic Surgery, Niigata Prefectural Central Hospital, Shinnancho 205, Joetsu-shi 943-0192, Japan;8. Department of Orthopedic Surgery, Niigata City General Hospital, Shumoku 463-7, Chuo-ku, Niigata-shi 950-1197, Japan;9. Department of Orthopedic Surgery, Tachikawa General Hospital, Kandamachi 3-2-11, Nagaoka-shi 940-8621, Japan;10. Department of Orthopedic Surgery, Tominaga-Kusano Orthopedic Hospital, Kouya 2-2-25, Sanjo-shi 955-0046, Japan;1. Hayashi Eye Hospital, Fukuoka, Japan;2. Department of Ophthalmology, National Hospital Organization Saitama Hospital, Saitama, Japan;3. Department of Ophthalmology, Keio University Faculty of Medicine, Keio University School of Medicine, Tokyo, Japan;2. Department of Cardiology, “Evaggelismos” General Hospital, Athens, Greece;3. 1st Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Athens, Greece;4. 1st Cardiology Division, AHEPA University Hospital, Medical School, University of Thessaloniki, Greece;5. Division of Cardiology, University of Ioannina Medical School, Ioannina, Greece, |
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| Abstract: | BackgroundBasicervical hip fractures are relatively rare with greater biomechanical instability compared to the other types of hip fractures. Several studies have reported ambivalent surgical outcomes of basicervical hip fractures. The purpose of this multicenter study was to analyze surgical outcomes of basicervical hip fractures according to the fixation type of proximal femur and lag screw type.MethodsAmong 3220 hip fractures, 145 were classified as basicervical hip fractures. Of those, 106 patients treated with osteosynthesis were included to analyze the surgical complications according to fixation type of proximal femur: sliding hip screw(SHS) and cephalomedullary nail (CMN) groups. Surgical complications including the excessive displacement of fracture and the occurrence of reoperation were evaluated at the final follow up. We further evaluated surgical complications according to lag screw type with subgroup analysis in CMN group: single screw type, blade type and two integrated screw type.ResultsTen patients (9.4%) sustained surgical complications (5 excessive displacements and 5 reoperations). For fixation type of proximal femur, SHS group showed higher tendency of excessive displacement despite no statistical difference between the two groups (p = 0.060). For lag screw type with subgroup analysis in CMN group, single screw type showed statistically high rates of reoperation compared to the other types of lag screw (p = 0.022).ConclusionBasicervical hip fractures treated with osteosynthesis resulted to high rates of surgical complications in this study. However, they could be drastically reduced if CMN with blade type or two integrated screw type were used in the osteosynthesis of basicervical hip fractures. |
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