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Acta ortopédica mexicana

Print version ISSN 2306-4102

Abstract

HERNANDEZ-POZOS, L; REYES-MARTINEZ, F; BERNAL-CAMARILLO, VE  and  LAGUNAS-SANCHEZ, CE. Factors associated with mediate complications in postoperative patients with transtrochanteric fractures with 135o dynamic hip screw system. Acta ortop. mex [online]. 2021, vol.35, n.6, pp.521-528.  Epub Oct 10, 2022. ISSN 2306-4102.  https://doi.org/10.35366/105705.

Introduction:

Transtrochanteric fractures represent 50% of proximal femur fractures, with a higher incidence in patients older than 65 years. The objective of the study is to evaluate the association of orthopedic factors with the presence of mediate complications in post-operative geriatric patients for transtrochanteric fractures with the 135o dynamic hip screw (DHS) system.

Material and methods:

Retrospective, analytical study. We evaluated patients older than 65 years with transtrochanteric fractures treated with 135o DHS. We analyzed pre-surgical, post-surgical, and 3 and 6-month radiographs. We performed a descriptive analysis of the population characteristics, comparison analysis of means (Mann-Whitney U) and proportions (chi square), correlation analysis, and a logistic regression model to determine the degree of association of the factors with mediate complications.

Results:

We evaluated 92 patients with a mean age of 83 ± 6.7 years. We evidenced mediate orthopedic complications in 8.7%; considering as the most frequent the cut-out (5.4%). In the correlation analysis, the peak apex index > 25 has a weak correlation (r = 0.372), the peak apex index modified to calcar > 27 moderate correlation (r = 0.528). The lateral cervico-diaphyseal angle > 20° has a high correlation (r = 0.7). In the regression analysis, the latter was associated with the presence of mediate orthopedic complications (OR 4.93, CI 1.2-15.81, p = 0.000).

Conclusions:

A correlation was observed between factors such as tip apex index > 25, tip apex index modified to calcar > 27 and cervical-lateral diaphyseal angle > 20o with the presence of complications, highlighting the latter as the factor that presents association with statistically significant differences.

Keywords : Complications; fractures; osteosynthesis; factors; plate; hip.

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