Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Guimarães, João Antônio Matheus; Guimarães, Ana Carolina Abdon; Franco, José Sergio

doi:10.1590/s0102-36162008000900006

Cited by 17 publications

(16 citation statements)

References 31 publications

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“…Although the pattern fracture of reverse obliquity (Tronzo V or AO 31 A3) has been reported as the most frequent type in some case series of unstable fractures, 9 , 24 most studies have described as the most prevalent types those classified as Tronzo III or IV (or AO 31 A2), 1 , 18 , 25 , 26 which agrees with our results. When comparing males and females, we found no statistically significant differences in relation to fracture type according to the classification of Tronzo.…”

Section: Discussionsupporting

confidence: 92%

“…Regarding the epidemiological findings observed in the present study, there is a vast literature attesting the female predominance and an age close to 80 years in other series. 1 , 9 , 18 , 21 , 23 This reflects the decrease in bone mineral density. We found no statistically significant difference between the ages of male and female patients.…”

Section: Discussionmentioning

confidence: 99%

“…Only exceptionally the procedure will be conservative in patients with comorbidities that contraindicate anesthesia, surgery, or both. 1 , 8 , 9 It is essential that the stability of the fracture be determined, so that the surgeon can properly choose the method to be employed. Unstable fractures are those lesions involving the posterior‐medial cortex and that feature reverse trace or subtrochanteric extension.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures

Takano

Moraes

Almeida

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze the influence of femoral neck diameter in the positioning of the sliding screw in cefalomedulares nails for treatment of unstable transtrochanteric fractures.MethodsProspectively throughout 2011, patients with unstable fractures transtrochanteric undergoing osteosynthesis with cephalomedullary nail using antirotacional device. They were evaluated for sex, age and fracture classification according to Tronzo. Through digital radiographs angle reduction, tip apex distance (TAD), stem diameter and measures between the positioning of the screws and the limits of the cervix were measured.ResultsOf the 58 patients, 42 (72.4%) were female and 16 (27.6%) were male. 33 patients were classified as Tronzo III (56.9%), 6 patients as Tronzo IV (10.4%) and 19 as Tronzo V (19.8%). The majority were in between the eighth and ninth decade of life. The average reduction in the angle was 130.05° for females and 129.4° for males. The TAD average was 19.7 mm for females and 21.6 for males. The average diameter of the neck and head vary with statistical significance between men and women. In 19 patients the placement of the sliding bolt can be optimal. If the ideal positioning was not possible, the mean displacement for non‐infringement of higher cortical neck was 4.06 mm.ConclusionThe optimal placement would not be possible for the majority of the population, for the average diameter of the neck of the sample.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures

Takano

Moraes

Almeida

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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“…Thus, there is a greater tendency towards positioning the sliding screw at a lower location on AP radiographs, especially in patients with a short femoral head and neck. Despite this proviso, this index has been used by some authors for assessing whether implants have been positioned correctly (15) . In our study, we found a mean tip-apex index of 22.8 (standard deviation of 8.3).…”

Section: Discussionmentioning

confidence: 99%

Avaliação prospectiva da evolução clínica, radiográfica e funcional do tratamento das fraturas trocantéricas instáveis do fêmur com haste cefalomedular

Borger

Leite

Araújo³

et al. 2011

Rev. bras. ortop.

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Objective: To assess the clinical, radiological and functional evolution of osteosynthesis using a cephalomedullary nail, in unstable trochanteric fractures of the femur, over a one-year postoperative follow-up. Methods: Fourteen men and 23 women of mean age 77.7 years were evaluated. Twenty-seven of them had fractures classified as AO/ASIF 31A2 and ten as 31A3. The patients were evaluated clinically, radiologically and functionally one week, two weeks, one month, two months, six months and one year after the operation. Results: The clinical complications comprised five cases of death, one case of calcaneal ulcer, one case of acute arterial obstruction and two cases of deep vein thrombosis. The radiographic evaluation showed that the mean cervicodiaphyseal angle in the immediate postoperative period was 132.5°. The mean tip-apex index was 22.8 mm. After one year,

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“…Femoral pertrochanteric fractures (FPF) typically occur in patients presenting diverse types of comorbidities and are associated with a high rate of mortality in the first year after the event [2]. …”

Section: Introductionmentioning

confidence: 99%

Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications

et al. 2011

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BackgroundZ-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis.FindingsThe paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications.ConclusionsAlthough intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality.

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Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Cited by 17 publications

References 31 publications

Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures

Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures

Avaliação prospectiva da evolução clínica, radiográfica e funcional do tratamento das fraturas trocantéricas instáveis do fêmur com haste cefalomedular

Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications

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