Intertrochanteric fracture fixation with Dynamic Hip Screw: Is tip-apex distance measurement useful for predicting fixation failure?
| Autor: | Mohamed Azril Ma, Zamzuri Z, Goh Kian Liang, Mohd Ariff S |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
030203 arthritis & rheumatology Orthodontics medicine.medical_specialty Dynamic hip screw business.industry Radiography Tip apex distance Retrospective cohort study General Medicine Acetabulum Surgery 03 medical and health sciences Fixation (surgical) 0302 clinical medicine medicine Implant Intertrochanteric fracture business |
| Zdroj: | IIUM Medical Journal Malaysia. 15 |
| ISSN: | 2735-2285 1823-4631 |
| DOI: | 10.31436/imjm.v15i1.404 |
| Popis: | Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture. |
| Databáze: | OpenAIRE |
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