Late postoperative analysis of the tip-apex distance (TAD) in pertrochanteric fractures: is there an accommodation of the implant within the bone?

Autor: Aihara LJ; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil. Electronic address: leandroaihara@hotmail.com., Nanni RA; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil., Carvalho MS; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil., Zamboni C; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil., Durigan JR; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil., Hungria Neto JS; Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil., Mercadante MT; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil; Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil., Christian RW; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil; Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil., Hungria JOS; Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Injury [Injury] 2017 Oct; Vol. 48 Suppl 4, pp. S54-S56.
DOI: 10.1016/S0020-1383(17)30776-3
Abstrakt: Introduction: This study measured the tip-apex distance (TAD) values in the immediate postoperative period and following weight-bearing and fracture impaction in patients undergoing osteosynthesis with dynamic hip screw and cephalomedullary nail.
Objective: To correlate the Baumgaertner index in the immediate postoperative period with values obtained after impaction of the fracture with the accommodation of the cephalic implant in the femoral head.
Patients and Methods: Radiographic TAD measurements were taken with AGFA-VIEW ® of 82 patients with a mean age of 72 years with pertrochanteric fractures who were operated on and the fracture fixed with DHS- Synthes ® , TFN-Synthes ® , or Gamma Nail III-Stryker ® in the immediate postoperative period, and following weight-bearing and fracture impaction (mean 3-8 weeks after surgery).
Results: The overall average TAD decreased from 20.3mm to 18.2mm. Regardless of the instability of the fracture, the age of the patient or the implant used, TAD decreased between the immediate postoperative period and following fracture impaction.
Conclusion: The osteosynthesis of pertrochanteric fractures was associated with important accommodation of the cephalic implant in the femoral head with decreased TAD values after weight-bearing.
(© 2017 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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