Pre-Fixation Compression Screw as a Cutting- Edge Technique for Varus Correction during Proximal Femoral Nailing of Intertrochanteric Fractures: A Retrospective Observation
Authors/Creators
- 1. Senior Resident, Department of Orthopaedics, Darbhanga Medical Cillege and Hospital, Darbhanga, Bihar, India
- 2. Professor and HOD, Department of Orthopaedics, Darbhanga Medical Cillege and Hospital, Darbhanga, Bihar, India
Description
Background: Intertrochanteric fractures are common in the ageing population and are typically treated using proximal femoral nailing (PFN). Achieving optimal alignment, particularly varus correction, is crucial for suc-cessful outcomes. The use of a pre-fixation compression screw presents a novel technique in this context. Aim: This study aims to evaluate the efficacy and products of using a pre-fixation compression screw for varus correction during PFN in patients with intertrochanteric fractures. Methods: In a retrospective study conducted at Darbhanga Medical College, 100 patients with intertrochanteric fractures were treated using proximal femoral nailing with a pre-fixation compression screw. The study aimed to evaluate the effectiveness of this innovative technique for varus correction. Data were collected on patient de-mographics, preoperative and postoperative neck shaft angles, intraoperative blood loss, surgery duration, and postoperative complications. Statistical analysis was performed using SPSS version 21.0. Results: The results showed a noteworthy improvement in varus correction, with the neck shaft angle increasing from 121.6 degrees preoperatively to 135.6 degrees postoperatively. The technique did not significantly increase intraoperative blood loss (average 34.67 ml) or surgery duration (average 19.46 minutes). The overall complica-tion rate was low at 10%, with the most common issues being superficial wound infections. These findings suggest that the pre-fixation compression screw is an effective and safe method for correcting varus deformity in intertrochanteric fractures. Conclusion: The pre-fixation compression screw technique offers improved varus correction and alignment in PFN for intertrochanteric fractures without significantly increasing operative time or blood loss. This technique also promotes faster healing times. Recommendations: Future studies should focus on larger sample sizes and randomized controlled trials to fur-ther validate the benefits of the pre-fixation compression screw technique. Additionally, long-term follow-up is recommended to assess the durability of outcomes.
Abstract (English)
Background: Intertrochanteric fractures are common in the ageing population and are typically treated using proximal femoral nailing (PFN). Achieving optimal alignment, particularly varus correction, is crucial for suc-cessful outcomes. The use of a pre-fixation compression screw presents a novel technique in this context. Aim: This study aims to evaluate the efficacy and products of using a pre-fixation compression screw for varus correction during PFN in patients with intertrochanteric fractures. Methods: In a retrospective study conducted at Darbhanga Medical College, 100 patients with intertrochanteric fractures were treated using proximal femoral nailing with a pre-fixation compression screw. The study aimed to evaluate the effectiveness of this innovative technique for varus correction. Data were collected on patient de-mographics, preoperative and postoperative neck shaft angles, intraoperative blood loss, surgery duration, and postoperative complications. Statistical analysis was performed using SPSS version 21.0. Results: The results showed a noteworthy improvement in varus correction, with the neck shaft angle increasing from 121.6 degrees preoperatively to 135.6 degrees postoperatively. The technique did not significantly increase intraoperative blood loss (average 34.67 ml) or surgery duration (average 19.46 minutes). The overall complica-tion rate was low at 10%, with the most common issues being superficial wound infections. These findings suggest that the pre-fixation compression screw is an effective and safe method for correcting varus deformity in intertrochanteric fractures. Conclusion: The pre-fixation compression screw technique offers improved varus correction and alignment in PFN for intertrochanteric fractures without significantly increasing operative time or blood loss. This technique also promotes faster healing times. Recommendations: Future studies should focus on larger sample sizes and randomized controlled trials to fur-ther validate the benefits of the pre-fixation compression screw technique. Additionally, long-term follow-up is recommended to assess the durability of outcomes.
Files
IJPCR,Vol16,Issue5,Article255.pdf
Files
(280.4 kB)
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Additional details
Dates
- Accepted
-
2024-05-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue5,Article255.pdf
- Development Status
- Active
References
- 1. Shetty M, Kumar S, Sagar SK, Kumar AA. Pre fixation compression screw as a cutting-edge technique for varus correction during proximal femoral nailing for intertrochanteric fractures: A study on 46 cases. Int J Orthop Sci. 2021. 2. Fan S, Yin M, Xu Y, Ren C, Ma T, Lu Y, et al. Locking compression plate fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity: a retrospective study. J Orthop Surg Res. 2021; 16 :24-30. 3. Deng X, Liu J, Qu T, Li X, Zhen P, Gao Q, Xue Y, Liu P, Cao G, He X. Total hip arthroplasty with femoral osteotomy and modular prosthesis for proximal femoral deformity. Journal of Orthopaedic Surgery and Research. 2019 Dec;14:1-8. 4. Nherera L, Trueman P, Horner A, Watson T, Johnstone AJ. Comparison of a twin interlocking derotation and compression screw cephalomedullary nail (InterTAN) with a single screw derotation cephalomedullary nail (proximal femoral nail antirotation): a systematic review and meta-analysis for intertrochanteric fractures. J Orthop Surg Res. 2018; 13:46.