PDF(Sci-hub)
Abstract：
OBJECTIVE: Infections after intramedullary fixation of trochanteric femoral fractures are rare, but potentially life-threatening complications. There are limited data available to support decision making in these cases.
METHODS: A retrospective study of 995 consecutive operatively treated trochanteric fractures was made to find out different risk factors for infection and to describe the results of treatment.
RESULTS: 28 patients developed a surgical site infection (2.8%) after intramedullary fixation of trochanteric fracture. 15 patients (1.5%) had a deep and 13 patients (1.3%) a superficial surgical site infection. Cigarette smoking (p<0.05) and prolonged operative time (p<0.05) were significant risk factors for an infection. 15 of 28 patients needed revision surgeries. Implant removal or exchange was needed only for 4 of 28 patients: 1 exchange of the blade, 1 removal of additional cable used to assist reduction and 2 removals of distal locking screws. None of the patients needed additional surgeries for problems with fracture healing. Mortality was not increased among patients with an infection.
CONCLUSIONS: Infection after intramedullary fixation of trochanteric fractures can be successfully treated without removal or exchange of the fixation material.
METHODS: A retrospective study of 995 consecutive operatively treated trochanteric fractures was made to find out different risk factors for infection and to describe the results of treatment.
RESULTS: 28 patients developed a surgical site infection (2.8%) after intramedullary fixation of trochanteric fracture. 15 patients (1.5%) had a deep and 13 patients (1.3%) a superficial surgical site infection. Cigarette smoking (p<0.05) and prolonged operative time (p<0.05) were significant risk factors for an infection. 15 of 28 patients needed revision surgeries. Implant removal or exchange was needed only for 4 of 28 patients: 1 exchange of the blade, 1 removal of additional cable used to assist reduction and 2 removals of distal locking screws. None of the patients needed additional surgeries for problems with fracture healing. Mortality was not increased among patients with an infection.
CONCLUSIONS: Infection after intramedullary fixation of trochanteric fractures can be successfully treated without removal or exchange of the fixation material.
摘要：
目的：股骨粗隆间骨折髓内固定术后感染少见，但可能危及生命的并发症.在这些情况下，可用于支持决策的数据有限。
方法：对995例连续手术治疗的股骨转子骨折进行回顾性研究，以找出感染的不同危险因素并描述治疗结果。
结果：28例患者在股骨转子骨折髓内固定术后出现手术部位感染（2.8%）。15例患者（1.5％）有深度感染，13例患者（1.3％）有浅表手术部位感染。吸烟（p<0.05）和手术时间延长（p<0.05）是感染的重要危险因素。28例患者中有15例需要翻修手术。28名患者中只有4名需要移除或更换植入物：1次更换刀片，1移除用于辅助复位的额外电缆，2移除远端锁定螺钉。没有一个患者需要额外的手术来解决骨折愈合问题。感染患者的死亡率没有增加。
结论：股骨转子骨折髓内固定术后感染可以在不移除或更换固定材料的情况下成功治疗。
方法：对995例连续手术治疗的股骨转子骨折进行回顾性研究，以找出感染的不同危险因素并描述治疗结果。
结果：28例患者在股骨转子骨折髓内固定术后出现手术部位感染（2.8%）。15例患者（1.5％）有深度感染，13例患者（1.3％）有浅表手术部位感染。吸烟（p<0.05）和手术时间延长（p<0.05）是感染的重要危险因素。28例患者中有15例需要翻修手术。28名患者中只有4名需要移除或更换植入物：1次更换刀片，1移除用于辅助复位的额外电缆，2移除远端锁定螺钉。没有一个患者需要额外的手术来解决骨折愈合问题。感染患者的死亡率没有增加。
结论：股骨转子骨折髓内固定术后感染可以在不移除或更换固定材料的情况下成功治疗。
