Key result
Temporary K-wire stabilization is not associated with reduced loss of reduction versus standard intramedullary nailing.
Why the study?
Maintenance of reduction during and after intramedullary nailing for intertrochanteric fractures remains a concern, and the role of temporary K-wire stabilization is advocated but not well established.
Does intraoperative temporary K-wire stabilization reduce intra/post-operative loss of reduction in patients with intertrochanteric fractures undergoing intramedullary nailing?
Cohort (n=80)
Non-randomized
No
Does intraoperative temporary K-wire stabilization reduce intra/post-operative loss of reduction in patients with intertrochanteric fractures undergoing intramedullary nailing?
Absolute Event Rate: 4.4% vs 17.1%
p-value: p=0.129
Temporary K-wire stabilization during intramedullary nailing for intertrochanteric fractures showed a non-significant trend towards reduced loss of reduction compared to no K-wire.
Should not yet change practice; leaves open whether randomized trials would confirm benefit of temporary K-wire stabilization.
Background: Inter-trochanteric fractures are one of the most common hip fractures, occurring in both young adults and the elderly, as a result of high-energy trauma or low-energy trauma. These fractures are three to four times more common in elderly women with osteoporosis. The primary concern with Intertrochanteric fractures is the 20% to 30% mortality risk in the first year after the fracture. Methods: Various methods of fracture fixation have been used in treating this fracture with intramedullary nailing has been the most favoured. In this modality maintenance of reduction during and after fixation remains a concern. The temporary stabilization of fracture with K-wires for minimally invasive fixation of Intertrochanteric fracture with an intramedullary nail is advocated and aids in keeping the fracture reduction in place while proximal reaming and nail introduction. Results: In this study a total of 80 patients with intertrochanteric fractures were included, of which 45 patients operated with temporary K-wire, 43 patients reduction was maintained and loss of reduction was noted in 2 patients (4.4%) and 35 patients operated without K-wire, 29 patients reduction maintained and lost in 6 patients (17.1%). Conclusions: There was no statistically significant, difference in the 2 groups with respect to intra/post-operative loss of reduction. Having a larger study group the results may have a statistically significant outcome.
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Yashwanth et al. (2023) conducted a cohort in Intertrochanteric femur fracture (n=80). Intramedullary nailing with intraoperative temporary K-wire stabilization vs. Intramedullary nailing without intraoperative temporary K-wire stabilization was evaluated on Loss of reduction intraoperatively/postoperatively (p=0.129). Intraoperative temporary K-wire stabilization during intramedullary nailing for intertrochanteric fractures did not significantly reduce the rate of loss of reduction compared to no K-wire stabilization (4.4% vs 17.1%, p=0.129).
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