Tip-apex distance of intramedullary devices as a predictor of cut-out failure in the treatment of peritrochanteric elderly hip fractures
A tip-apex distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cut-out when sliding hip screws (SHS) are used to treat peritrochanteric (PT) hip fractures. The purpose of this study was to determine which factors, including TAD, correlated with successful cli...
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| Veröffentlicht in: | International orthopaedics 2010-06, Vol.34 (5), p.719-722 |
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| creator | Geller, Jeffrey A. Saifi, Comron Morrison, Todd A. Macaulay, William |
| description | A tip-apex distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cut-out when sliding hip screws (SHS) are used to treat peritrochanteric (PT) hip fractures. The purpose of this study was to determine which factors, including TAD, correlated with successful clinical outcomes of PT hip fractures surgically treated with intramedullary (IM) devices. A total of 192 patients were included in this retrospective study. The TAD values of this cohort were radiographically analysed at a mean follow-up of 13 months. This was correlated with limited functional status and the rate of revision for implant failure or inability to achieve fracture union. Only 82 patients had adequate follow-up to fracture union or definitive failure. There were 46 intertrochanteric (IT) hip fractures and 36 subtrochanteric (ST) fractures. Overall, seven patients (8.5%) went on to experience lag screw cut-out. The average TAD of the patients who did not cut-out was 18 mm, compared to 38 mm for those who did (
p
= 0.012). All patients who cut-out had IT fractures (
p
= 0.017). The percentage of cut-outs correlated directly to both the severity of IT fractures and the TAD. Using a cutoff of 25 mm there was a statistically significant difference in the incidence of lag screw cut-out (
p
|
| doi_str_mv | 10.1007/s00264-009-0837-7 |
| format | Article |
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p
= 0.012). All patients who cut-out had IT fractures (
p
= 0.017). The percentage of cut-outs correlated directly to both the severity of IT fractures and the TAD. Using a cutoff of 25 mm there was a statistically significant difference in the incidence of lag screw cut-out (
p
< 0.001). As in sliding hip screws, surgeons should strive for a TAD less than 25 mm when using IM devices in the treatment of PT hip fractures to help avoid lag screw cut-out.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-009-0837-7</identifier><identifier>PMID: 19618186</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Bone Screws ; Female ; Femur Head - anatomy & histology ; Femur Head - diagnostic imaging ; Fracture Fixation, Intramedullary - instrumentation ; Fracture Fixation, Intramedullary - methods ; Fracture Healing ; Hip Fractures - physiopathology ; Hip Fractures - surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Original Paper ; Orthopedics ; Predictive Value of Tests ; Prosthesis Failure ; Radiography ; Recovery of Function ; Reoperation ; Retrospective Studies ; Treatment Outcome</subject><ispartof>International orthopaedics, 2010-06, Vol.34 (5), p.719-722</ispartof><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-e256c6541d50e4a7204c11a4a0f2a13af7d80a7504ec424797fe53d525c76d9b3</citedby><cites>FETCH-LOGICAL-c507t-e256c6541d50e4a7204c11a4a0f2a13af7d80a7504ec424797fe53d525c76d9b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903170/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903170/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,41467,42536,51298,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19618186$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Geller, Jeffrey A.</creatorcontrib><creatorcontrib>Saifi, Comron</creatorcontrib><creatorcontrib>Morrison, Todd A.</creatorcontrib><creatorcontrib>Macaulay, William</creatorcontrib><title>Tip-apex distance of intramedullary devices as a predictor of cut-out failure in the treatment of peritrochanteric elderly hip fractures</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>A tip-apex distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cut-out when sliding hip screws (SHS) are used to treat peritrochanteric (PT) hip fractures. The purpose of this study was to determine which factors, including TAD, correlated with successful clinical outcomes of PT hip fractures surgically treated with intramedullary (IM) devices. A total of 192 patients were included in this retrospective study. The TAD values of this cohort were radiographically analysed at a mean follow-up of 13 months. This was correlated with limited functional status and the rate of revision for implant failure or inability to achieve fracture union. Only 82 patients had adequate follow-up to fracture union or definitive failure. There were 46 intertrochanteric (IT) hip fractures and 36 subtrochanteric (ST) fractures. Overall, seven patients (8.5%) went on to experience lag screw cut-out. The average TAD of the patients who did not cut-out was 18 mm, compared to 38 mm for those who did (
p
= 0.012). All patients who cut-out had IT fractures (
p
= 0.017). The percentage of cut-outs correlated directly to both the severity of IT fractures and the TAD. Using a cutoff of 25 mm there was a statistically significant difference in the incidence of lag screw cut-out (
p
< 0.001). As in sliding hip screws, surgeons should strive for a TAD less than 25 mm when using IM devices in the treatment of PT hip fractures to help avoid lag screw cut-out.</description><subject>Aged</subject><subject>Bone Screws</subject><subject>Female</subject><subject>Femur Head - anatomy & histology</subject><subject>Femur Head - diagnostic imaging</subject><subject>Fracture Fixation, Intramedullary - instrumentation</subject><subject>Fracture Fixation, Intramedullary - methods</subject><subject>Fracture Healing</subject><subject>Hip Fractures - physiopathology</subject><subject>Hip Fractures - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Predictive Value of Tests</subject><subject>Prosthesis Failure</subject><subject>Radiography</subject><subject>Recovery of Function</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcuKFTEQhoMozvHoA7iR7FxFK_fujSCDNxhwM65DJl09J0OfTpukB-cNfGzTnIOXjRBIoL7_r1T9hLzk8IYD2LcFQBjFAHoGnbTMPiI7rqRgmvf6MdmBVJwJ0-sL8qyUOwBuTcefkgveG97xzuzIz-u4ML_gDzrEUv0ckKaRxrlmf8RhnSafH-iA9zFgob4dumQcYqgpb2BYK0trpaOP05qxCWk9IK0ZfT3iXDdmwRxrTuHg59qegeI0YJ4e6CEudMw-1KYsz8mT0U8FX5zvPfn28cP15Wd29fXTl8v3VyxosJWh0CYYrfigAZW3AlTg3CsPo_Bc-tEOHXirQWFQQtnejqjloIUO1gz9jdyTdyffZb1pEwbcRp3ckuOxjeqSj-7fyhwP7jbdO9GD5BaaweuzQU7fVyzVHWMJ2DY1Y1qLs1JqbcDwRvITGXIqJeP4uwsHtwXoTgG6FqDbAmzaPXn19_f-KM6JNUCcgNJK8y1md5fWPLeV_cf1F5zpqhA</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Geller, Jeffrey A.</creator><creator>Saifi, Comron</creator><creator>Morrison, Todd A.</creator><creator>Macaulay, William</creator><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100601</creationdate><title>Tip-apex distance of intramedullary devices as a predictor of cut-out failure in the treatment of peritrochanteric elderly hip fractures</title><author>Geller, Jeffrey A. ; Saifi, Comron ; Morrison, Todd A. ; Macaulay, William</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-e256c6541d50e4a7204c11a4a0f2a13af7d80a7504ec424797fe53d525c76d9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Bone Screws</topic><topic>Female</topic><topic>Femur Head - anatomy & histology</topic><topic>Femur Head - diagnostic imaging</topic><topic>Fracture Fixation, Intramedullary - instrumentation</topic><topic>Fracture Fixation, Intramedullary - methods</topic><topic>Fracture Healing</topic><topic>Hip Fractures - physiopathology</topic><topic>Hip Fractures - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Predictive Value of Tests</topic><topic>Prosthesis Failure</topic><topic>Radiography</topic><topic>Recovery of Function</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Geller, Jeffrey A.</creatorcontrib><creatorcontrib>Saifi, Comron</creatorcontrib><creatorcontrib>Morrison, Todd A.</creatorcontrib><creatorcontrib>Macaulay, William</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Geller, Jeffrey A.</au><au>Saifi, Comron</au><au>Morrison, Todd A.</au><au>Macaulay, William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tip-apex distance of intramedullary devices as a predictor of cut-out failure in the treatment of peritrochanteric elderly hip fractures</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>34</volume><issue>5</issue><spage>719</spage><epage>722</epage><pages>719-722</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>A tip-apex distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cut-out when sliding hip screws (SHS) are used to treat peritrochanteric (PT) hip fractures. The purpose of this study was to determine which factors, including TAD, correlated with successful clinical outcomes of PT hip fractures surgically treated with intramedullary (IM) devices. A total of 192 patients were included in this retrospective study. The TAD values of this cohort were radiographically analysed at a mean follow-up of 13 months. This was correlated with limited functional status and the rate of revision for implant failure or inability to achieve fracture union. Only 82 patients had adequate follow-up to fracture union or definitive failure. There were 46 intertrochanteric (IT) hip fractures and 36 subtrochanteric (ST) fractures. Overall, seven patients (8.5%) went on to experience lag screw cut-out. The average TAD of the patients who did not cut-out was 18 mm, compared to 38 mm for those who did (
p
= 0.012). All patients who cut-out had IT fractures (
p
= 0.017). The percentage of cut-outs correlated directly to both the severity of IT fractures and the TAD. Using a cutoff of 25 mm there was a statistically significant difference in the incidence of lag screw cut-out (
p
< 0.001). As in sliding hip screws, surgeons should strive for a TAD less than 25 mm when using IM devices in the treatment of PT hip fractures to help avoid lag screw cut-out.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>19618186</pmid><doi>10.1007/s00264-009-0837-7</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Bone Screws Female Femur Head - anatomy & histology Femur Head - diagnostic imaging Fracture Fixation, Intramedullary - instrumentation Fracture Fixation, Intramedullary - methods Fracture Healing Hip Fractures - physiopathology Hip Fractures - surgery Humans Male Medicine Medicine & Public Health Original Paper Orthopedics Predictive Value of Tests Prosthesis Failure Radiography Recovery of Function Reoperation Retrospective Studies Treatment Outcome |
| title | Tip-apex distance of intramedullary devices as a predictor of cut-out failure in the treatment of peritrochanteric elderly hip fractures |
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