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Radiographic Review of Helical Blade Versus Lag Screw Fixation for Cephalomedullary Nailing of Low-Energy Peritrochanteric Femur Fractures: There is a Difference in Cutout.
- Source :
-
Journal of orthopaedic trauma [J Orthop Trauma] 2017 Jun; Vol. 31 (6), pp. 305-310. - Publication Year :
- 2017
-
Abstract
- Objectives: To compare the rate of cutout of helical blades and lag screws in low-energy peritrochanteric femur fractures treated with a cephalomedullary nail (CMN).<br />Design: Retrospective review.<br />Setting: Academic medical center.<br />Patients: Overall, this study included 362 patients with an average age of 83 year old, a majority of whom were women, and had sustained a low-energy peritrochanteric femur fracture treated with a CMN. All patients had at least 3 months of clinical and radiographic follow, with an average follow-up of 11 months and a range of 3-88 months follow-up.<br />Intervention: Cephalomedullary nailing with the use of a helical blade or single lag screw for proximal fixation.<br />Main Outcome Measurements: Cutout of the helical blade or lag screw.<br />Results: Twenty-two cutouts occurred, 14 (15.1%) of 93 patients with helical blades and 8 (3.0%) of 269 patients with lag screws. Cutout with the helical blade was significantly more frequent than with the lag screw (P = 0.0001). The average tip-apex distance (TAD) was significantly greater for those patients who experienced cutout both for the helical blades (23.5 vs. 19.7 mm; P = 0.0194) and lag screws (24.5 vs. 20.0 mm; P = 0.0197). An absolute TAD predictive of cutout could not be determined.<br />Conclusions: When the helical blade was used, implant cutout occurred at a significantly higher rate compared with lag screw fixation. There was not a threshold TAD that was predictive of cutout for either implant.<br />Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Aged
Aged, 80 and over
Bone Screws classification
Equipment Failure Analysis
Female
Femoral Fractures epidemiology
Fracture Fixation, Intramedullary methods
Fracture Healing
Humans
Longitudinal Studies
Male
Prevalence
Prosthesis Design
Treatment Outcome
Virginia epidemiology
Bone Screws statistics & numerical data
Femoral Fractures diagnostic imaging
Femoral Fractures surgery
Fracture Fixation, Intramedullary instrumentation
Fracture Fixation, Intramedullary statistics & numerical data
Prosthesis Failure
Subjects
Details
- Language :
- English
- ISSN :
- 1531-2291
- Volume :
- 31
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic trauma
- Publication Type :
- Academic Journal
- Accession number :
- 28346314
- Full Text :
- https://doi.org/10.1097/BOT.0000000000000853