Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9752-9761
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9752
Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly
Xiao-Wen Huang, Gu-Qi Hong, Qiang Zuo, Qun Chen
Xiao-Wen Huang, Gu-Qi Hong, Qiang Zuo, Qun Chen, Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, Jiangsu Province, China
Author contributions: Huang XW and Hong GQ performed the research and drafted the paper; Chen Q designed and supervised the research; Zuo Q contributed to data analysis; All authors contributed to editing, reviewing and final approval of article.
Supported by the National Natural Science Foundation of China, No. 81902206.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the first Affiliated Hospital of Nanjing Medical University.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qun Chen, MD, Professor, Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), No. 300 Guangzhou Road, Gulou District, Nanjing 210029, Jiangsu Province, China. jsphgk001@aliyun.com
Received: May 12, 2021
Peer-review started: May 12, 2021
First decision: June 15, 2021
Revised: June 28, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: November 16, 2021
Processing time: 181 Days and 18.3 Hours
ARTICLE HIGHLIGHTS
Research background

For elderly patients with type 31A3 irreducible intertrochanteric fractures, intracortical screw technology plus limited open reduction is a novel surgical treatment modality and meaningful clinical attempt, which could achieve high-quality fracture reduction and fixation.

Research motivation

For type 31A3 irreducible intertrochanteric fractures, traditional intraoperative reduction methods are more traumatic, and it is difficult to maintain fracture reduction. Therefore, surgical procedures that can achieve and maintain reduction without causing too much trauma are needed. We innovatively combined intracortical screw technology and limited open reduction for irreducible intertrochanteric fractures in the elderly.

Research objectives

To explore and discuss clinical efficacy of intracortical screw insertion plus limited open reduction in type 31A3 irreducible intertrochanteric fractures in elder patients.

Research methods

A retrospective analysis was performed on 23 elderly patients with type 31A3 irreducible intertrochanteric fractures who received intracortical screw insertion plus limited open reduction treatment at our orthopedics department. The operation time, intraoperative blood loss, intraoperative X-ray dose, fracture union time, reduction effects and functional recovery scores of the hip joint were evaluated.

Research results

The operation time was 53.8 ± 13.6 min. The intraoperative blood loss was 218.5 ± 28.6 mL. The average number of intraoperative X-rays was 22.8 ± 4.6. The average time to fracture union was 4.8 ± 0.7 mo. The reduction effects revealed by Kim’s fracture reduction evaluation was assessed as grade I in 20 cases and grade II in 3 cases, with an excellent to good rate of 100%. The functional recovery scores score in the last follow-up was not significantly different from the functional recovery scores score before the fracture.

Research conclusions

Good clinical outcomes and high-quality fracture reduction were achieved by using intracortical screw technology and limited open reduction in patients with type 31A3 irreducible intertrochanteric fractures without increasing operation time and intraoperative blood loss.

Research perspectives

Intracortical screw technology requires continual improvement and optimization. More randomized clinical trials are required to verify our findings.