New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail

김, 준영; 최, 기홍; 양, 규현

doi:10.4055/jkoa.2020.55.3.193

Cited by 8 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Theoretically, the trabecular bone surrounding the helical blade may function to resist further advancement of the lag screw. Therefore, it can be hypothesized that in the femoral head with weak bone strength, resistance may not be sufficient to prevent medial migration 26 , 27 .…”

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis analyzing association between bone mineral density and lag screw migration

Lee

Kim

et al. 2023

Sci Rep

View full text Add to dashboard Cite

A proximal femoral nail using a helical blade (HB) is commonly utilized to treat proximal femoral fracture but cut through failure of the lag screws is one of the devastating complications following the surgery. While controversial, one of the potential risk factors for cut through failure is poor bone strength which can be predicted by measuring bone mineral density (BMD). In this study, we performed a biomechanical test on the fractured femoral head to validate whether the indirectly measured BMD from the contralateral hip or that measured directly from the retrieved femoral head can elucidate the structural strength of the fractured femoral head and thereby can be used to predict migration of lag screws. Our result showed that directly measured BMD has a significant correlation with the HB migration on the osteoporotic femoral head. However, while the BMDs measured from the contralateral femoral neck or total hip is the most widely used parameter to predict the bone strength of the fractured femur, this may have limited usability to predict HB migration.

show abstract

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis analyzing association between bone mineral density and lag screw migration

Lee

Kim

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Therefore, it can be hypothesized that in the femoral head with weak bone strength, resistance may not be su cient to prevent medial migration. [20] , [21] One of the most widely used methods to predict bone strength is measuring the BMD using DXA. However, the BMD largely represents the quantity of the trabecular bone, while bone mass is one of the important factors contributing to bone strength; the mechanical properties of the bone are also con gured with other factors, such as architecture geometry, cortical porosity, and tissue mineralization density.…”

Section: Discussionmentioning

confidence: 99%

Can the Bone Mineral Density of the Non-fractured Contralateral Hip Predict Medial Migration of Helical Blade-type Lag Screws in Osteoporotic Hip Fractures?

Jo¹,

Lee²,

Lee

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In this study, we performed a biomechanical tests on the osteoporotic femoral heads to validate whether the bone mineral density (BMD) measured at the non-fractured contralateral hip can predict the BMD and potential medial migration of helical blade-type lag screws on the fractured femoral head.Methods: Twenty-four osteoporotic femoral heads were retrieved from patients with femoral neck fracture undergoing hip arthroplasty. The patients had their BMD measured from the contralateral hip using dual-energy X-ray absorptiometry prior to surgery. The BMD of the retrieved femoral heads was measured using micro-computed tomography. The mechanical properties for the medial migration of lag screw were measured by performing an uniaxial compression test on the femoral head using a helical blade-type lag screw. Statistical analysis was performed to determine the correlation among the BMDs of the non-fractured contralateral hip and the retrieved femoral head and the mechanical properties of the fractured femoral head.Results: The mean BMD of the contralateral hip was 0.60±0.14 g/cm2 in the neck region and 0.63±0.15 g/cm2 in the total proximal femur. The mean BMD of the fractured femoral head was 463.3±48.05 mg HA/cm3. The mechanical properties of the fractured femoral head were measured to be 0.92 kN for the maximum compressive load and 14.50±5.48 kN for the accumulated compression load. In the analysis of the correlation among the parameters, we found no correlation between the BMD of the non-fractured contralateral hip and the mechanical properties of the fractured femoral head. In addition, we observed no correlation between the BMD of the fractured femoral head and that of the contralateral hip.Conclusions: Our results indicate that the BMD of the contralateral hip does not reflect the BMD or the mechanical properties of the fractured femoral head. Therefore, helical blade-type lag screw migration may not be predicted from the BMD of the non-fractured contralateral hip.

show abstract

“…The purpose of surgical treatment for ITF is to reduce the potential for complications by obtaining anatomical reduction with firm fixation to enable a pre-fracture level of function. Wide use of dynamic hip screws, cephalomedullary nail (CM nail), bipolar hip arthroplasty, and CM nail, which are less invasive and offer biomechanical advantages, for treatment of ITF has recently been reported 6 7 8) . In general, in postoperative radiographic examination, the tip-apex distance (TAD) must be within 25 mm to be considered stable 9 10 11 12 13) .…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail

Ryu,

Shin,

Han

et al. 2023

Hip & Pelvis

View full text Add to dashboard Cite

Purpose Cephalomedullary (CM) nailing is widely performed in treatment of elderly patients with femoral intertrochanteric fractures. However, in cases of fixation failure, re-operation is usually necessary, thus determining factors that may contribute to fixation failure is important. In this study, we examined factors affecting the occurrence of fixation failure, such as age or fracture stability, after CM nailing in elderly patients. Materials and Methods This study was conducted retrospectively using registered data. From April 2011 to December 2018, CM nailing was performed in 378 cases diagnosed with femoral intertrochanteric fractures, and 201 cases were finally registered. Cases involving patients who were bed-ridden before injury, who died from causes unrelated to surgery, and those with a follow-up period less than six months were excluded. Results Fixation failure occurred in eight cases. Comparison of the surgical success and fixation failure group showed that the mean age was significantly higher in the fixation failure group compared with the control group (81.3±6.4 vs. 86.4±6.8; P =0.034). A significantly high proportion of unstable fractures was also observed (139/54 vs. 3/5; P =0.040), with a significantly high ratio of intramedullary reduction (176/17 vs. 5/3; P =0.034). A significantly higher ratio of unstable fractures compared with that of stable fractures was observed in the intramedullary reduction group (132/49 vs. 10/10; P =0.033). Conclusion Fixation failure of CM nailing is likely to occur in patients who are elderly or have unstable fracture patterns. Thus, care should be taken in order to avoid intramedullary reduction.

show abstract

New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail

Cited by 8 publications

References 22 publications

Biomechanical analysis analyzing association between bone mineral density and lag screw migration

Biomechanical analysis analyzing association between bone mineral density and lag screw migration

Can the Bone Mineral Density of the Non-fractured Contralateral Hip Predict Medial Migration of Helical Blade-type Lag Screws in Osteoporotic Hip Fractures?

Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail

Contact Info

Product

Resources

About