Evaluation of the quadrants of femoral neck-head in the cephalomedullary fixation of intertrochanteric fractures with a helical blade: Is inferior posterior quadrant also safe? A clinical study
Amaç & Hipotez:Objectives: This study aims to investigate the positioning of the helical blade to prevent mechanical complications in surgically fixed intertrochanteric fractures (ITFs).Patients and methods: In this retrospective study, 392 patients (158 males, 234 females; mean age: 75.5±13.4; range, 20 to 101) years) with ITFs treated in lateral decubitus position with proximal femoral nail anti-rotation in a single center between January 2009 and January 2017 were evaluated.
📊
Temel Bulgular & Veri:Patients with an unstable fracture, proper TAD, and acceptable or good reduction were included in the final evaluation for statistical analysis to investigate the safest quadrant to prevent cut-out complication.Results: Cut-out complications were observed in 19 (4.8%) patients.
💡
Sonuç & Katkı:The scenario; unstable fracture, TAD
🔬Tür:Araştırma Makalesi
📍Kapsam:2009 Verileri
⚙️Değişkenler:Alan Parametreleri
Abstract
Objectives: This study aims to investigate the positioning of the helical blade to prevent mechanical complications in surgically fixed intertrochanteric fractures (ITFs).Patients and methods: In this retrospective study, 392 patients (158 males, 234 females; mean age: 75.5±13.4; range, 20 to 101) years) with ITFs treated in lateral decubitus position with proximal femoral nail anti-rotation in a single center between January 2009 and January 2017 were evaluated. The fractures were classified according to the Orthopedic Trauma Association classification preoperatively and grouped as stable or unstable. Postoperatively, tip-apex distance (TAD), Baumgaertner reduction criteria, and obtained quadrants were evaluated. Patients with an unstable fracture, proper TAD, and acceptable or good reduction were included in the final evaluation for statistical analysis to investigate the safest quadrant to prevent cut-out complication.Results: Cut-out complications were observed in 19 (4.8%) patients. The scenario; unstable fracture, TAD
🔖
Bu Makaleye Atıf Yap
TURGUT, A., KOCA, A., KARAPINAR, L., KUMBARACI, M. (2022). Evaluation of the quadrants of femoral neck-head in the cephalomedullary fixation of intertrochanteric fractures with a helical blade: Is inferior posterior quadrant also safe? A clinical study. Joint diseases and related surgery, Cilt: 32 - Sayı: 1, 93–100. https://ajindex.com/articles/559269
Oh JK, Hwang JH, Sahu D. Nailing of intertrochanteric fractures: review on pitfalls and technical tips. JOTR 2010;14:3-7
Turgut A, Kalenderer Ö, Karapınar L, Kumbaracı M, Akkan HA, Ağuş H. Which factor is most important for occurrence of cutout complications in patients treated with proximal femoral nail antirotation? Retrospective analysis of 298 patients. Arch Orthop Trauma Surg 2016;136:623-30
Cleveland M, Bosworth DM, Thompson FR, Wilson HJ Jr, Ishizuka T. A ten-year analysis of intertrochanteric fractures of the femur. J Bone Joint Surg [Am] 1959;41:1399-408
Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM. The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg [Am] 1995;77:1058-64
Kane P, Vopat B, Heard W, Thakur N, Paller D, Koruprolu S, et al. Is tip apex distance as important as we think? A biomechanical study examining optimal lag screw placement. Clin Orthop Relat Res 2014;472:2492-8
Goffin JM, Pankaj P, Simpson AH. The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: a subject-specific finite element study. J Orthop Res 2013;31:596-600
Liu W, Zhou D, Liu F, Weaver MJ, Vrahas MS. Mechanical complications of intertrochanteric hip fractures treated with trochanteric femoral nails. J Trauma Acute Care Surg 2013;75:304-10
Aguado-Maestro I, Escudero-Marcos R, García-García JM, Alonso-García N, Pérez-Bermejo D D, Aguado-Hernández HJ, et al. Resultados y complicaciones de la osteosíntesis de fracturas pertrocantéreas de fémur mediante clavo endomedular con espiral cefálica (clavo femoral proximal antirrotación) en 200 pacientes [Results and complications of pertrochanteric hip fractures using an intramedullary nail with a helical blade (proximal femoral nail antirotation) in 200 patients]. Rev Esp Cir Ortop Traumatol 2013;57:201-7
De Bruijn K, den Hartog D, Tuinebreijer W, Roukema G. Reliability of predictors for screw cutout in intertrochanteric hip fractures. J Bone Joint Surg [Am] 2012;94:1266-72
Sadic S, Custovic S, Jasarevic M, Fazlic M, Smajic N, Hrustic A, et al. Proximal femoral nail antirotation in treatment of fractures of proximal femur. Med Arch 2014;68:173-7
Güven M, Yavuz U, Kadioğlu B, Akman B, Kilinçoğlu V, Unay K, et al. Importance of screw position in intertrochanteric femoral fractures treated by dynamic hip screw. Orthop Traumatol Surg Res 2010;96:21-7. 12.