Extent and Morbidity of Lateralization of a Trochanteric Fixation Nail Blade
| Autor: | Phillip A Sandifer, Clay A. Spitler, George V Russell, Matthew L Graves, LaRita C Jones, Patrick F. Bergin, Josie M. Hydrick, Robert M. Hulick |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Radiography Bone Nails 03 medical and health sciences Femoral head 0302 clinical medicine Postoperative Complications Foreign-Body Migration Risk Factors Statistical significance medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Aged 80 and over 030222 orthopedics Femur fracture Calcar business.industry Hip Fractures Trauma center 030208 emergency & critical care medicine Middle Aged Surgery Fracture Fixation Intramedullary medicine.anatomical_structure Orthopedic surgery Female business Complication |
| Zdroj: | Orthopedics. 40(5) |
| ISSN: | 1938-2367 |
| Popis: | This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded. Medical records were reviewed to identify symptomatic hardware. Overall, 27 patients (19.1%) were symptomatic, and 3 (2.1%) required revision surgery for blade prominence. Of the patients, 42 (30%) had lateralization of greater than 1 cm, and 16 of these (38.1%) were symptomatic ( P P =.054). Lateralization of greater than 1 cm was directly associated with the presence of symptoms ( P P =.007). Multivariate analysis showed that increasing tip-apex distance, inadequate calcar reduction, and greater fracture severity were predictive of excessive lateralization of greater than 1 cm. Nearly 20% of patients had lateral hip pain associated with cephalomedullary fixation. Final lateralization of the helical blade of greater than 1 cm was a very strong predictor of symptoms. During preoperative counseling, surgeons should caution patients about this relatively frequent and likely underreported complication. [ Orthopedics. 2017; 40(5):e886–e891.] |
| Databáze: | OpenAIRE |
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