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Results of osteosynthesis with the ITST nail in fractures of the trochanteric region of the femur

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Abstract

A prospective study is presented of 551 hip fractures treated with the ITST (inter-trochanteric/sub-trochanteric) nail with a minimum mandatory follow-up of 1 year. Of the patients 73% were female, the rest male. The average age was 82.8 years. Fractures were classified according to the AO system, the most common sub-type recorded being the A2 (56%). Clinical and radiographic controls were performed at 1, 3, 6 and 12 months. The system allowed early mobilisation and walking in the majority of our patients, along with fracture consolidation in an acceptable time (12 weeks on average). There were technical complications during the operation in 10.5% of the cases, complications in the immediate postoperative period in 22.3% and late complications were detected in 5.1% of patients at 12 months. The ability to recover previous walking ability was 58%. The ITST nail emerges as a good system of osteosynthesis for fractures of the trochanteric region of the femur, allowing early weight-bearing, which favours bone consolidation. The surgical technique is not complex, the number of complications recorded is acceptable and the overall results obtained are comparable and even superior to those obtained with other osteosynthesis systems available for treatment of this type of fracture.

Résumé

Nous présentons une étude prospective de 551 fractures de la hanche traitées par le clou ITST avec un minimum de suivi de 1 an. 73% des patients étaient des femmes, les autres patients des hommes. L’âge moyen était de 82.8 ans. Les fractures ont été classées selon le système AO, le type le plus fréquent étant le type A2 (56%). L’examen clinique et radiographique a été réalisé à 1, 3, 6 et 12 mois. Ce système d’ostéosynthèse permet une mobilisation précoce et la marche pour une grande majorité des patients, avec un temps de consolidation acceptable de 12 semaines en moyenne. Les complications techniques durant l’intervention ont été de 10.5%, post opératoires immédiat de 22.3% et tardives de 5.1% à 12 mois. Les patients ont récupéré une marche identique à celle qu’ils avaient avant l’intervention dans 58% des cas. Le clou ITST nous apparaît comme un bon système d’ostéosynthèse pour ces fractures de la région trochantérienne, permettant un appui précoce avec une bonne consolidation osseuse. La technique chirurgicale est simple, le nombre de complications rapportées est acceptable, les résultats obtenus sont comparables ou souvent supérieurs à ceux obtenus avec d’autres systèmes d’ostéosynthèse pour le même type de fracture.

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Correspondence to Antonio Herrera.

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Herrera, A., Domingo, J. & Martinez, A. Results of osteosynthesis with the ITST nail in fractures of the trochanteric region of the femur. International Orthopaedics (SICO 32, 767–772 (2008). https://doi.org/10.1007/s00264-007-0411-0

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