Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

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.