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Greater rate of cephalic screw mobilisation following proximal femoral nailing in hip fractures with a tip-apex distance (TAD) and a calcar referenced TAD greater than 25 mm.
- Source :
-
Journal of orthopaedic surgery and research [J Orthop Surg Res] 2018 May 02; Vol. 13 (1), pp. 106. Date of Electronic Publication: 2018 May 02. - Publication Year :
- 2018
-
Abstract
- Background: To ascertain whether the tip-apex distance (TAD), calcar referenced TAD (CalTAD), and the sum of both (TADcalTAD) are predictive measurements of mobilisation of the cephalic screw in patients with trochanteric hip fractures.<br />Methods: Between 2014 and 2015, 68 patients (mean age 86 years, 45 females, 23 males) with a trochanteric hip fracture underwent intramedullary nailing. The TAD and CalTAD were measured, and for each parameter, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).<br />Results: There is evidence of a statistically significant association between a TAD and CalTAD greater than 25 mm and a TADcalTAD greater than 50 mm and mobilisation of the cephalic screw. All measurements have similar sensitivity, but the TAD presents the highest specificity (p < 0.01).<br />Conclusion: To avoid the risk of mobilisation of the cephalic screw and possible subsequent failure of the construct, surgeons should strive for a TAD and CalTAD less than 25 mm and a TADcalTAD less than 50 mm when using intramedullary fixation.
- Subjects :
- Aged
Aged, 80 and over
Female
Femur surgery
Fracture Fixation, Intramedullary instrumentation
Fracture Fixation, Intramedullary methods
Hip Fractures surgery
Humans
Male
Reference Standards
Bone Nails standards
Bone Screws standards
Femur diagnostic imaging
Fracture Fixation, Intramedullary standards
Hip Fractures diagnostic imaging
Prosthesis Failure
Subjects
Details
- Language :
- English
- ISSN :
- 1749-799X
- Volume :
- 13
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic surgery and research
- Publication Type :
- Academic Journal
- Accession number :
- 29720223
- Full Text :
- https://doi.org/10.1186/s13018-018-0814-1