A Evaluation of Initial Treatment of Trochanteric Fractures using Gamma Nails

  • Quang-Tri LE PhD Director of 7A MILITARY HOSPITAL Head of Department of Orthopedic, 7AMILITARY HOSPITAL 466 NguyenTrai Street, Ward 8, District 5, Ho Chi Minh City, 72706 Vietnam Phone:(+084)08-39241868, (+084)0913126229
  • Minh-Hoang Nguyen

Abstract

Background: Trochanteric fractures are extra-joint fractures, account for 55% of femoral proximal fractures. They often happen in the elderly with increased frequency due to age. Treatment experiences at 7A Military Hospital showed increased trochanteric fracture cases. To properly assess treatment effectiveness and select proper treatment methods, the study of “Evaluation of initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques” was carried out.


The study objectives are evaluating the initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques.


Methods and findings: nineteen patients diagnosed with traumatic trochanteric fractures and surgically treated with Gamma nails were monitored and evaluated for bone fusion, bone union, range of motion, limb shortening, and functional rehabilitation according to Merle D'Aubigné scale.


Fourteen patients (82.35%) achieved proper bone union with the femoral neck-shaft angle of 1250 - 1300, three patients (17.65%) got slightly deviated bone union. Amongst patients aged under 60, 14/17 cases (82.35%) achieved “good” and “very good” functional rehabilitation, scored over 15 points according to Merle D΄aubigne Index; 3/17 cases (17.65%) got “average” recovery. Hip range of motion in 14 cases (82.35%) achieved “very good” (normal movement) or “good” (over 10% movement limitation) outcome, 3 cases had “average” movement (17.65%). Limb shortening of below 1cm took place in 10 patients (58.82%), 1 – 2 cm in 4 patients (23,53%) and over 3 cm in 3 patients (17.65%).


Conclusions: The surgical treatment of trochanteric fractures using gamma nails yielded positive outcomes.


Keywords: Gamma nails, trochanteric fractures, elderly, extra-joint.

Author Biographies

Quang-Tri LE, PhD Director of 7A MILITARY HOSPITAL Head of Department of Orthopedic, 7AMILITARY HOSPITAL 466 NguyenTrai Street, Ward 8, District 5, Ho Chi Minh City, 72706 Vietnam Phone:(+084)08-39241868, (+084)0913126229

PhD Director of 7A MILITARY HOSPITAL

Head of Department of Orthopedic, 7AMILITARY HOSPITAL

466 NguyenTrai Street, Ward 8, District 5, Ho Chi Minh City, 72706

Vietnam

Phone:(+084)08-39241868, (+084)0913126229

Minh-Hoang Nguyen

Department of Orthopedic, 7A Military Hospital

466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706

Vietnam (hoangbss@gmail.com)

References

1. Maville JA, Huerta CG. Health promotion in nursing. 3rd ed. USA: Delmar; 2013.
2. Le VT. Evaluation of trochanteric fractures treatment using Gamma nails at Cho Ray Hospital. Ho Chi Minh Orthopedics Association. Jul 2007. (In Vietnamese)
3. Biau DJ, Brand RA. Robert Merle d’Aubigne, 1900–1989. Clin Orthop Relat Res. 2009;467(1):2-6.
4. Vo TP. Physical health of aged over 65 patients and orpthopedic surgery. J Med News. 2004 Apr;9(2):81-3. (In Vietnamese)
5. Adam P. Treatment of recent trochanteric fracture in adults. Orthop Traumatol Surg Res. 2014 Feb;100(1):S75-S83.
6. Lustosa LP, Bastos EO. (2009). Proximal fracture of the femur on the elderly: what's the best treatment?. Acta Ortopédica Brasileira. 2009;17(5):309-12.
7. Ricardo M. Treatment of Intertrochanteric Hip Fractures in Elderly High Risk Patients with External Fixation. Orthop Rheumatol. 2016 Oct;3(2).
8. Ghoneem HF, Zayda AI, El Sayed AFA. Treatment of intertrochanteric fracture femur by Ilizarov fixator in elderly patients. Menoufia Med J. 2018;31(4):1293-8.
9. Gulcelik NE, Bayraktar M, Caglar O, Alpaslan M, Karakaya J. Mortality after hip fracture in diabetic patients. Exp Clin Endocrinol Diabetes. 2011 May;119(07):414-18.
10. Li Y, Lin J, Cai S, Yan L, Pan Y, Yao X, Zhuang H, Wang P, Zeng Y. (2016). Influence of bone mineral density and hip geometry on the different types of hip fracture. Bosnian J Basic Med. 2016 Feb;16(1):35-8.
11. Lin JC-F, Liang W-M. Mortality and complications after hip fracture among elderly patients undergoing hemodialysis. BMC Nephrol, 2015;16.
12. Baumgarten M, Margolis DJ, Orwig DL, Shardell MD, Hawkes WG, Langenberg P et al. Pressure ulcers in elderly patients with hip fracture across the continuum of care. J Am Geriatr Soc. 2009 May;57(5):863-70.
13. Yamaguchi R, Jono O, Hamasaki A, Sakamoto A, Tatsumoto T, Kita M et al. Early Operation for Femoral Trochanteric Fracture in Elderly: Cause of Delayed Operation. Orthop Traumatol. 2012 Jun;61(2):265–9.
Published
2020-01-21
How to Cite
LE, Quang-Tri; NGUYEN, Minh-Hoang. A Evaluation of Initial Treatment of Trochanteric Fractures using Gamma Nails. International Archives of Medicine, [S.l.], v. 13, jan. 2020. ISSN 1755-7682. Available at: <http://imedicalpublisher.com/ojs/index.php/iam/article/view/2917>. Date accessed: 20 jan. 2021. doi: https://doi.org/10.3823/2619.
Section
Traumatology and Orthopedics