Abstract：
The incidence of proximal femur fractures is increasing due to aging of the population. Intramedullary nails are the mainstay of treatment for intertrochanteric hip fractures mainly due to their better biomechanical properties compared to dynamic hip screw devices, shorter operative time, and less blood loss during surgery. However intramedullary nail fixation is not devoid of complications. The purpose of this study is to look at complications related to intramedullary nailing for intertrochanteric hip fractures in a major trauma center. A retrospective study was conducted including all patients having suffered an intertrochanteric femur fracture and treated with intramedullary nails from October 1, 2020, to October 1, 2022, in the Orthopaedic Surgery Clinic. The intramedullary hip systems used were the Stryker Gamma3 Nail and the VITUS PF Nail. All complications following the postoperative period were recorded in detail. Overall, 240 patients with a mean age of 82.3 years treated with hip intramedullary devices were identified. Superior cutout of the lag screw in two patients (females 90 and 87 years old) was identified 8 and 10 weeks following initial surgery. Avascular necrosis (AVN) of the femoral head was identified in one patient (male 81 years old) which occurred 12 weeks postoperatively. All three cases were revised by replacing the nail with cemented hemiarthroplasty. Periprosthetic fractures occurred in an 88-year-old male and a 73-year-old female following an injury distal to the stem and were managed by replacing the nail with a long stem device (Long Gamma3). One case of metalwork fracture was also recorded. There are many advantages in managing intertrochanteric hip fractures with intramedullary hip devices such as shorter theater time, less blood loss, and improved biomechanical properties. However, complications such as cutout of the lag screw, AVN, and periprosthetic fracture are serious and require complex revision surgery.
摘要：
由于人口老龄化，股骨近端骨折的发生率正在增加。髓内钉是治疗股骨粗隆间髋部骨折的主要原因是其与动力髋螺钉装置相比具有更好的生物力学特性,手术时间更短，手术期间失血更少。然而，髓内钉固定并非没有并发症。这项研究的目的是在主要创伤中心观察与髓内钉治疗股骨粗隆间髋部骨折相关的并发症。进行了一项回顾性研究，包括2020年10月1日至2022年10月1日在骨科诊所接受股骨粗隆间骨折并接受髓内钉治疗的所有患者。使用的髓内髋关节系统是StrykerGamma3钉和VITUSPF钉。详细记录术后所有并发症。总的来说,240名平均年龄为82.3岁的患者接受了髋关节髓内装置治疗。初次手术后8周和10周，确定了两名患者（女性90岁和87岁）的方头螺钉的优越切口。在1例患者（男性81岁）中发现股骨头缺血性坏死（AVN），发生在术后12周。所有三例病例均通过用水泥半髋关节置换术代替指甲进行了修正。在茎远端受伤后，一名88岁的男性和一名73岁的女性发生了假体周围骨折，并通过用长茎装置（LongGamma3）替换指甲来进行管理。还记录了一例金属制品断裂。使用髓内髋关节装置治疗股骨粗隆间骨折有许多优点，例如缩短手术时间，减少失血,和改善的生物力学特性。然而,并发症，如方头螺钉的切口，AVN,假体周围骨折严重，需要复杂的翻修手术。
