Effect of Comorbidities and Choice of Fixation on the Onset of Bone Healing Time on Surgically Treated Intertrochanteric Femoral Fractures/Cerrahi Olarak Tedavi Edilen Intertrokanterik Femur Kiriklarinda Eslik Eden Durumlarin ve Fiksasyon Seciminin Kemik Iyilesme Suresinin Baslangicina Etkisi

• Published in: Medical journal of Bakirköy Vol. 17; no. 3; p. 173
• Main Authors: Bayrak, Alkan, Duramaz, Altug
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.09.2021
• Subjects: Care and treatment; Complications and side effects; Fractures; Internal fixation in fractures; Patient outcomes; Turkey
• ISSN: 1305-9319
• DOI: 10.4274/BMJ.galenos.2021.99815

Objective: This study aimed to evaluate whethercomorbidities affect the onset of bone healing time (BHT) in surgically treated intertrochanteric femoral fractures (IFFs). Methods: The study comprised 55 patients (12 male and 43 female) who underwent surgical treatment of IFFs. The mean age of patients was 79.29 [+ or -] 81.13 years. The fractures were classified according to the AO Classification. Twenty-one patients were treated with dynamic hip screw, 15 with an external fixator, and 1 9 with proximal femoral nail. Thirty-one patients had comorbidities such as diabetes and hypertension. Results: Patients were divided into three groups according to the BHT. Group 1 had BHT<30 days (G1), group 2 had BHT 30-60 days (G2), and group 3 had BHT >60 days (G3). There were no statistically significant differences among the groups in terms of age, sex, additional disease, and the fixation method. There were statistically significant differences among the groups in terms of receiving intensive care unit (ICU) treatment. The rates of ICU referral in G3 were significantly higher than those in G1, statistically close to being meaningfully higher than those in G2. Discharge duration was close to being meaningful in patients with more than one comorbidity. Conclusion: Fixation type, age, and comorbidities did not affect BHT. Patients with more than one comorbidities had long hospitalization time owing to their prolonged preoperative surgical preparation time and postoperative evaluation of comorbidities. Keywords: Intertrochanteric femoral fractures, fracture healing, fixation method, proximal femoral nail, dynamic hip screw Amac: Bu calismanin amaci intertrokanterik femur kiriklari (IFK) olan hastalarin cerrahi tedavisinde komorbiditelerin ve fiksasyon yontemlerinin, kaynamaya baslama suresini (KBS) etkileyip etkilemedigini degerlendirmektir. Gerec ve Yontem: Calismaya IFK nedeniyle cerrahi tedavi uygulanan 55 hasta (12 erkek ve 43 kadin) alindi. Hastalarin yas ortalamasi 79,29 [+ or -] 81,13 yil (61,6 ile 91,5 yil arasinda degismekteydi). Kiriklar AO siniflamasina gore siniflandirildi. Yirmi bir hasta dinamik kalca vidasi (DHS) ile tedavi edildi, 15 hasta eksternal fiksator (EF) ile tedavi edildi, 1 9 hasta proksimal femoral civi (PFN) ile tedavi edildi. Otuz bir hastanin diyabet, hipertansiyon vb. gibi ek hastaliklari vardi. Bulgular: Hastalar kaynamaya baslama suresine gore uc gruba ayrildi. KBS'si <30 gun grup 1 (G1), 30-60 gun grup 2 (G2),>60 gun grup 3 (G3) olarak degerlendirildi. Gruplar arasinda (G1, G2, G3) yas, cinsiyet, ek hastalik ve fiksasyon yontemi acisindan istatistiksel olarak anlamli bir fark saptanmadi. Gruplar arasinda postoperatif donemde yogun bakim unitesine (YBU) refere edilme orani acisindan istatistiksel olarak anlamli farklar vardi. G3'te YBU refere edilme oranlari G1 'den anlamli olarak yuksekti, istatistiksel olarak G2'den anlamliliga yakin yuksekti. Birden fazla komorbiditesi olan hastalarin hastanede yatis suresi diger hastalardan anlamliliga yakin derecede yuksekti. Sonuc: Fiksasyon tipi, yas ve komorbiditelerin KBS'sini etkilemedigi gozlenmistir. Birden fazla komorbiditesi olan hastalarin, uzun preoperatif cerrahi hazirlik suresi ve ek hastaliklarin postoperatif donemde kontrol edilmesi nedeniyle hastanede yatma surelerinin daha uzun oldugu gozlendi. Anahtar Kelimeler: intertrokanterik femur kiriklari, kirik iyilesmesi, fiksasyon teknigi, proksimal femoral civi, kayan kalca vidasi