Simple guidelines for evaluating intraoperative alignment after the reduction of intertrochanteric fractures
| Autor: | Jinil Kim, Jong Keon Oh, Jae-Woo Cho, Hyung Jin Kim, Yong-Cheol Yoon, Won-Tae Cho |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Intertrochanteric fractures
Adult Male Greater trochanter medicine.medical_treatment lcsh:Surgery 3D modeling Fracture Fixation Internal Young Adult 03 medical and health sciences Femoral head Quadrant (abdomen) Bone Anteversion Imaging Three-Dimensional 0302 clinical medicine Anterior cortical line Cadaver Anteversion Monitoring Intraoperative Early ambulation medicine Humans Internal fixation Reduction (orthopedic surgery) Greater trochanter orthogonal line Neck-shaft angle Hip Fractures business.industry Femur Head lcsh:RD1-811 Middle Aged medicine.anatomical_structure 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Intertrochanteric fracture Tomography X-Ray Computed Nuclear medicine business |
| Zdroj: | Asian Journal of Surgery, Vol 44, Iss 1, Pp 66-71 (2021) |
| ISSN: | 1015-9584 |
| DOI: | 10.1016/j.asjsur.2020.10.010 |
| Popis: | Summary The incidence of intertrochanteric femoral fractures has rapidly increased with the extended lifespan of the elderly population. Surgery enables early ambulation by achieving anatomic reduction and stable internal fixation. However, reduction usually involves postoperative evaluation. Here, we present reliable parameters obtained from analyses of three-dimensional computed tomography images from cadavers to serve as guidelines during the reduction of intertrochanteric fractures. We included 184 three-dimensional modeling samples from cadavers placed in two standardized positions, similar to C-arm imaging. We recorded the level of the orthogonal line from the greater trochanter (GT) tip to the femoral head (GT orthogonal line [GTOL]) in the anteroposterior view and the line along the anterior femoral cortex passing through the femoral head (anterior cortical line) in the axial view. Correlations between these lines and angular alignments were statistically determined. The GTOL passed above the femoral head center at mean 2.36 mm in all patients; 77.17% of such instances were in the upper second quadrant of the femoral head. The anterior cortical line passed under the femoral head center at mean 10.82 mm; 73.37% of such instances were in the inferior one-third of the femoral head. Consistent correlations were found between the GTOL and neck-shaft angle and between the anterior cortical line and anteversion. The GTOL and anterior cortical line passed through a constant level of the femoral head in most samples and were correlated with angular alignments. The intraoperative use of these simple imaginary lines improves the intertrochanteric fracture reduction quality. |
| Databáze: | OpenAIRE |
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