Torsional malalignment, how much significant in the trochanteric fractures?

Kim, Tae Young; Lee, Yong Beom; Chang, Jun Dong; Lee, Sang Soo; Yoo, Jae Hyun; Chung, Ki Sup; Hwang, Jong Hee

doi:10.1016/j.injury.2015.07.015

Cited by 15 publications

(7 citation statements)

References 18 publications

(21 reference statements)

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“…This is because when the surgeon pushes the anterior cortex with an instrument, the proximal fragment can protrude posteriorly and the rotational malalignment of the proximal fragment can obstruct accurate reduction. 17) Chun et al 18) reported good reduction of anterior cortex by the percutaneous technique in sagittaly unstable trochanteric fractures.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Failure of Cephalomedullary Nail Fixation in the Treatment of Trochanteric Hip Fractures

et al. 2020

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The incidence of trochanteric fractures increases as the society ages. A trochanteric fracture is mostly caused by low-energy trauma in elderly patients with low bone mineral density (BMD), and morbidity and mortality rates after this fracture are high. 1) The goals of surgical treatment of a trochanteric fracture are to anatomically reduce and firmly stabilize the fracture to restore preinjury functions as soon as possible and to minimize medical and surgical complications. 1,2) Because intramedullary (IM) nails have biomechanical and minimally invasive advantages over sliding hip screws, IM nailing is widely performed for trochanteric fractures. One of the critical complications after

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Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Failure of Cephalomedullary Nail Fixation in the Treatment of Trochanteric Hip Fractures

et al. 2020

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“…Rotation of the proximal fragment or lag screw is related to the initiation of screw migration and consequent fixation failure [9], so many efforts for lag screw design, especially the prevention of rotation, have evolved. Proximal Femoral Nail Antirotation (PFNA) and Gamma 3 U-Blade screws represent some of the most evolved models for the control of the early motion of lag screws, such as toggling, rotation, and migration.…”

Section: Discussionmentioning

confidence: 99%

Gamma 3 U-Blade lag screws in patients with trochanteric femur fractures: are rotation control lag screws better than others?

et al. 2019

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BackgroundIntramedullary hip nails may be classified as blades or screws depending on the type of lag screw used. Recently, a combination of lag screw types with a U-clip insertion has also been used. The purpose of this study was to evaluate the clinical and radiological outcomes of these new screw types.MethodsA total of 185 patients with trochanteric femoral fractures (age ≥ 65 years) who underwent surgery with intramedullary nails were selected. Surgeries with InterTrochanteric/SubTrochanteric (ITST), Proximal Femoral Nail Antirotation (PFNA), and Gamma 3 U-Blade lag screws were performed between January 2011 and June 2016. The AO/OTA classification, presence of a basicervical fracture type on 3D-CT, BMI, BMD, reduction quality, position of the lag screw, TAD (tip apex distance) of the lag screw, sliding distance of the lag screw, varus change (neck shaft angle), radiological union period, fixation failure and functional outcome as determined by walking ability were analyzed.ResultsThere were 3/60 (5.0%) cases of fixation failure in the ITST group, all caused by cut-out; 4/57 (7.0%) in the PFNA II group: 3 caused by cut-through and 1 by metal fracture; 1/68 (1.5%) in the Gamma 3 U-Blade lag screw group (P = 0.301). In each group, the sliding distance of the lag screw showed a significant difference (P = 0.017), whereas significant sliding over 10 mm showed no statistically significant results.ConclusionThere was only one (1.5%) case of fixation failure in the Gamma 3 U-Blade lag screw group. The sliding distance of the U-Blade was found to be in the middle, between the PFNA II (shorter) and ITST (longer) implants. The new rotational control lag screw seems to be comparable to other screw types.

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“…1 Especially after intramedullary nailing of femoral shaft fractures maltorsion of more than 15°occurs in 15% to 41% of all patients. [2][3][4] Consequences are hip and/or knee pain that might be accompanied by restricted movement. 2,5,6 Another long-term problem following torsional malalignment of the femur is related to the risk of degenerative osteoarthritis of the knee and/or hip.…”

Section: Introductionmentioning

confidence: 99%

“…Being congenital or caused by fracture treatment, malalignment of the femur is a frequently encountered problem in orthopaedics and traumatology 1 . Especially after intramedullary nailing of femoral shaft fractures maltorsion of more than 15° occurs in 15% to 41% of all patients 2‐4 . Consequences are hip and/or knee pain that might be accompanied by restricted movement 2,5,6 .…”

Section: Introductionmentioning

confidence: 99%

In vivo test of a radiography‐based navigation system for control of derotational osteotomies

Grünwald

Schröter

Windolf

et al. 2020

Journal Orthopaedic Research

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Malalignment of the femur is a frequently encountered problem in orthopaedics entailing manifold consequences for the affected patients. Corrective osteotomies, necessary to restore the physiological and anatomical relationships, face great challenges due to no existing reliable gold standard for intraoperative control of torsional malalignment. The aim of this study was to test a novel radiography-based navigation tool for control of derotational osteotomies in a clinical environment. In a first-and preliminary-casecontrolled study on 12 patients (level 3 of evidence), the achieved torsional correction measured with implementation of the navigation tool was compared with measurements from pre-and postoperative computed tomography (CT) scans. The navigation tool was able to acquire and process all relevant data and capture possible malrotation during surgery with only little deviations of 1.61°± 0.86°(mean ± standard deviation) from the measurements based on CT scans. Next, the system will be used to assist surgeons for more precise treatment avoiding maltorsion after derotational osteotomies.

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Torsional malalignment, how much significant in the trochanteric fractures?

Cited by 15 publications

References 18 publications

Risk Factors Associated with Failure of Cephalomedullary Nail Fixation in the Treatment of Trochanteric Hip Fractures

Risk Factors Associated with Failure of Cephalomedullary Nail Fixation in the Treatment of Trochanteric Hip Fractures

Gamma 3 U-Blade lag screws in patients with trochanteric femur fractures: are rotation control lag screws better than others?

In vivo test of a radiography‐based navigation system for control of derotational osteotomies

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