Time to consolidation of lateral hip fractures, surgically treated with a Gamma-type cephalomedullary osteosynthesis nail

Abstract

Abstract: 

Introduction

Hip fractures occur more frequently in patients over 65 years of age, predominantly in females. Although there are multiple classifications of these fractures, the main concept of them is related to the irrigation of the proximal femoral epiphysis; medial or intracapsular ones affect circumflex vessels and future cephalic viability; lateral or extracapsular fractures would not compromise the terminal circulation of the femoral head. The surgical treatment of reduction and osteosynthesis is indicated in lateral fractures, in this way, the patient preserves his native joint; and this is different from arthroplasty, where a joint replacement is performed.

Objective

Determine the healing time of lateral hip fractures, surgically treated with a Gamma-type cephalomedullary osteosynthesis nail.

Material and methods

A series of cases was studied, which included patients who underwent surgery for lateral hip fracture, treated with Gamma-type cephalomedullary osteosynthesis. Those procedures performed during the year 2020 (January to December) were evaluated. An orthopedic and radiological follow-up was carried out, recording the time of consolidation of the fracture and rehabilitation to achieve gait.

Results

36 patients were included, 25 female and 11 male, with a mean age of 71 years (range 65 - 95 years). Regarding bone consolidation assessed by radiographic controls, it was obtained in 19 patients (52%) in the first four months after surgery, 5 cases (13%) had delayed union, which resolved with orthopedic treatment. 31% (12 patients) could not be assessed due to death or loss of follow-up. The recovery period that patients needed to return to their previous ambulation was 4.8 months on average. No patient was reoperated during follow-up.

Conclusions

Lateral hip fractures are surgically treated with a cephalomedullary nail, they achieve consolidation in adequate time, in more than half of the patients studied, allowing them to return to their ambulatory activity prior to surgery.