Tip apex distance - Is it enough to predict implant failure in trochanteric fractures
Journal Title: Indian Journal of Orthopaedics Surgery - Year 2017, Vol 3, Issue 4
Abstract
Introduction: The tip-apex distance (TAD) is the sum of the distances from the tip of lag screw to apex of the femoral head on both AP and lateral radiographs. A TAD of greater than 25 mm is considered to be an accurate predictor of lag screw cut-out when dynamic hip screws are used to treat intertrochanteric hip fractures. The purpose of this study was to determine the factors affecting the clinical outcomes of trochanteric fractures treated surgically. Materials and Methods: This retrospective study included 124 patients. The TAD values of this cohort were analysed from post-operative radiographs. The fractures were classified according to severity and the post-operative reduction and their affection to cut out rates was determined. These were correlated with functional status and inability to achieve fracture union at a mean follow-up of 12 months. Results: Good reduction was obtained in 28 cases of type 1 fractures while all the fractures which had poor reduction were type 2 fractures. All type 1 fractures united at a mean of 12 months. Overall 14 patients experienced lag screw cut-out, all of which were type 2 fractures. Discussion: The number of cut-outs had direct correlation to the severity of fractures and the TAD. While using dynamic hip screws, surgeons should try to achieve a TAD less than 25 mm to avoid lag screw cut-out. Though TAD plays a vital role in predicting implant failure in trochanteric fractures, quality of bone, fracture pattern, placement of screw etc also influence the outcome.
Authors and Affiliations
Biswajit Sahu, Alok Prusty, Barsha Tudu
Keywords
Related Articles
- EP ID EP295159
- DOI 10.18231/2395-1362.2017.0075
- Views 83
- Downloads 0
Desmoplastic fibroma of the ulna
Introduction Desmoplastic fibroma is an extremely rare locally aggressive benign bone tumour with incidence of 01 of primary bone tumorsIt is composed of spindle cells with minimal cytological atypia and abundant collage...
Comparison of Ilizarov and rail fixator in non union of long bones
Introduction Nonunion of long bones is a challenging scenario to deal with as management of such fractures is difficult Tibia is common site of non union1 Various modes of treatment are available such as ultrasound elect...
Percutaneous release of trigger finger: An easy and safe procedure
Introduction Trigger finger is caused by irritation of the flexor tendon as it slides through the fibroosseous sheath Its surgical options include open and percutaneous minimally invasive methodsAim This study is aimed a...
Managing clubfoot with Ponseti method: Our experience with children upto 3 years of age
Introduction Ponseti method has become the mainstay of congenital clubfoot treatment in children presenting at early age The initial efficacy rate of Ponseti method reaches almost 100 The Ponseti method is also effective...
Functional outcome of Primary total knee replacement in severe flexion deformity and without flexion deformity knee – A comparative study
Aims & Objectives: To know the functional outcome of Primary TKR in Severe fixed flexion deformity of knee compared with TKR in knees without fixed flexion deformity (FFD). Materials & Methods: This is a prospective stud...