Tip apex distance in dynamic hip screw fixation in patients with an extracapsular neck of femur fracture; an audit on change

George, David A.; Afsharpad, Arash; Nwaboku, Harold

doi:10.1016/j.ijsu.2013.06.393

Cited by 2 publications

(1 citation statement)

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“…In any case, instructing surgeons in the concept of the tip–apex distance has helped to increase the number of patients with satisfactory positioning of the lag screw [ 46 , 47 ], decreasing the frequency of cephalic screw mobilisation [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

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

Aicale

Maffulli

2018

J Orthop Surg Res

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BackgroundTo 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.MethodsBetween 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).ResultsThere 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).ConclusionTo 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.

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Section: Discussionmentioning

confidence: 99%