Erratum to: Risk factors in cutout of sliding hip screw in intertrochanteric fractures: an evaluation of 937 patients

Hsueh, Kuang-Kai; Fang, Chi-Kuang; Chen, Chuan-Mu; Su, Yu‐Ping; Wu, Heng-Fei; Chiu, Fang-Yao

doi:10.1007/s00264-011-1405-5

Cited by 3 publications

(2 citation statements)

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“…Implant position has been extensively reviewed in sliding hip screws, with recommendations including low in inferior neck position, center-center position, and a TAD <25 mm. 5,9 Surgical technique advocated by the AO group 10 and by the FNS manual 11 suggested a center-center position and subchondral placement of the guide pin mainly based on previous findings from studies for sliding hip screws. Our results have, however, indicated that failure could still occur in FNS bolts positioned in center-center positions.…”

Section: Discussionmentioning

confidence: 99%

Tip-to-apex distance does not predict fixation failure regardless of reduction quality in intra-capsular neck of femur fractures treated with femoral neck system

Leung,

Wong,

Fang

et al. 2023

Journal of Orthopaedics, Trauma and Rehabilitation

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Femoral neck system (FNS) is a novel fixed-angle gliding device combining a sliding bolt and an anti-rotational screw to treat femoral neck fractures. It was proven to have comparable biomechanical strength to sliding hip screws. Tip-to-apex distance (TAD) is an established assessment for fixation quality in sliding hip screws. The purpose of our study was to evaluate whether TAD can be used in FNS implant to predict fixation failure. Seventy-six patients receiving FNS fixation for intra-capsular hip fracture were included. TAD was measured from post-operative radiographs and clinical outcomes were collected with a mean follow-up of 14.1 months. The mean TAD for patients who experienced fixation failure was 20.7 mm, versus 19.7 mm for those who did not ( p = 0.395). Subgroup analysis among fractures with good reduction quality, defined as no varus angulation, less than 5 degrees of retroversion, and less than 4 mm cortical translation, did not demonstrate statistically significant difference in the mean TAD between failure and non-failure group (20.7 mm vs 19.5 mm, p = 0.68). We conclude that in our study of modest sample size, there was not demonstrable association between TAD and fixation failure in intra-capsular neck of femur patients treated with FNS.

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Section: Discussionmentioning

confidence: 99%

Tip-to-apex distance does not predict fixation failure regardless of reduction quality in intra-capsular neck of femur fractures treated with femoral neck system

Leung,

Wong,

Fang

et al. 2023

Journal of Orthopaedics, Trauma and Rehabilitation

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“…The Joint Committee on Surgical Training (JCST) require evidence of a minimum of 40 performed compression hip screw for the intertrochanteric neck of femur fracture, for certification following 72 months of orthopaedic training [7]. There is no doubt that a high-quality surgical fixation leads to better post-operative patient outcomes [8][9][10], and the use of fluoroscopic imaging helps to facilitate this. While it is important to 'Get it right first time' (GIRFT) [11] and ensure that key steps of the surgery are performed to a very high standard irrespective of the time (and radiation spent), a delicate balance must be struck between GIRFT and the optimisation of radiation exposure.…”

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confidence: 99%

Intraoperative Fluoroscopic Radiation Exposure During Hip Fracture Fixation: A Study Combining Surgical Experience and Fracture Complexity

Bruce¹,

De²,

Golmohamad³

et al. 2021

Cureus

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Aim Hip fracture fixation surgeries are one of the most common surgeries that every trauma unit does regularly. Surgical training and expertise to fix these fractures properly are quite crucial for every orthopaedic surgeon. Therefore, orthopaedic training programmes all over the world consider significant focus on this and teach trainee surgeons expectantly to manage these fractures independently. Surgical fixation of hip fractures often requires fluoroscopy assistance in the operating theatre with associated hazards from ionising radiation. Moreover, hip fractures can be sometimes quite complex and may require relatively more fluoroscopy usage even with the higher grade of the operating surgeons. Therefore, training need for hip fracture fixation surgery is imperative and there is also a need for intraoperative radiation safety. This study has tried to find a balance between intraoperative fluoroscopic radiation exposure, surgical training requirement, and hip fracture complexity. Methodology This single centre study has collected retrospective peri-operative data over a period of two years including hip fractures that required fluoroscopy-guided surgical fixation. Femoral head fractures, subtrochanteric fractures, diaphyseal fractures, and trochanteric fractures with associated pelvic fractures were excluded from the study. We collected data on demographic parameters, fracture complexity and grading (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association [AO/OTA] Classification), intraoperative ionising radiation exposure (centi-Gray/cm 2 ), and grade of the operating surgeon in order to find any relation between these factors. Results Total 268 patients were included in the study with a mean age of 81.8 years (SD 9.3) comprising of 83 (31%) male patients and 185 (69%) female patients. The study population was further stratified into three groups depending upon the operating grade of the surgeon: ‘Junior Trainee’ (five years of experience; 148 cases [55%]); and ‘Consultant’ (fully trained to practice independently; 43 cases [16%]). There was no statistically significant difference among these three sub-groups with regards to the age (p = 0.79), gender (p = 0.73), body mass index (p = 0.46), and fracture pattern (p = 0.96) of the patients. However, consultants tend to operate more on the higher American Society of Anesthesiologists (ASA) grade patients (p = 0.049) with more comorbidities. There was statistically significant higher fluoroscopic radiation exposure while junior trainee surgeons (p = 0.005) were operating and during the higher complex grade of hip fracture (p = <0.001) fixation. Conclusion In conclusion, the quantity of intra-operative radiation dose utilised in the surgical fixation of hip fractures is significantly associated with the grade and level of training of the operating surgeon and fracture complexity ...

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Improving Cephalad Lag Screw Placement in the Femoral Head During Cephalomedullary Nailing Using a Novel Augmented Reality System

Konda

Solasz

Derken

et al. 2023

Journal of Orthopaedic Trauma

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Objectives:To measure the effect of a novel augmented reality software designed to aid in lag screw placement into the femoral head for cephalomedullary nails.Design:Retrospective cohort study.Setting:Single Level I trauma center.Patients:Between November 2017 and December 2020, 114 consecutive patients with a hip fracture that underwent repair with a cephalomedullary nail by one of 2 orthopaedic trauma surgeons were reviewed. Fracture classifications included OTA/AO 31-A1, 31-A2, 31-A3, and 31-B3.Intervention:The first 57 patients underwent fracture repair without the software (control) and the subsequent 57 patients underwent repair with use of the augmented reality software (AR).Main Outcome Measurements:Tip apex distance (TAD) and femoral head zone (AP: superior, center, inferior; Lateral: anterior, center, posterior) were measured using standardized techniques.Results:The mean TAD was lower for the AR versus control cohort (10.7 ± 2.9 mm vs. 15.4 ± 3.8 mm; P < 0.001). TAD <10 mm for AR versus control: 25 (43.9%) versus 3 (5.3%), P < 0.001. TAD <15 mm for AR versus control: 50 (87.7%) versus 44 (77.2%), P < 0.001. On the AP view, center position was achieved in 50.9% versus 7.0% of cases for the AR versus control cohort, respectively. On the lateral view, center position was achieved in 68.4% versus 12.3% of cases for the AR versus control cohort, respectively.Conclusion:This study suggests that use of the novel augmented reality software for assistance in lag screw positioning within the femoral head improves overall TAD and ability to achieve the center–center position.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Erratum to: Risk factors in cutout of sliding hip screw in intertrochanteric fractures: an evaluation of 937 patients

Abstract: The stated country of the affiliation section of the original version unfortunately contained an error. The correct version is given below.The online version of the original article can be found at http://dx.doi.

Cited by 3 publications

References 0 publications

Tip-to-apex distance does not predict fixation failure regardless of reduction quality in intra-capsular neck of femur fractures treated with femoral neck system

Tip-to-apex distance does not predict fixation failure regardless of reduction quality in intra-capsular neck of femur fractures treated with femoral neck system

Intraoperative Fluoroscopic Radiation Exposure During Hip Fracture Fixation: A Study Combining Surgical Experience and Fracture Complexity

Improving Cephalad Lag Screw Placement in the Femoral Head During Cephalomedullary Nailing Using a Novel Augmented Reality System

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