TIP APEX DISTANCE OF INTRAMEDULLARY DEVICES AS A PREDICTOR OF CUT-OUT FAILURE IN TREATMENT OF PERITROCHANTERIC ELDERLY HIP FRACTURES
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 15
Abstract
BACKGROUND A Tip-Apex Distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cut-out when Sliding Hip Screws (SHS) are used to treat Peritrochanteric (PT) fractures. The purpose of this study was to determine, which factors, including TAD correlated with successful clinical outcomes of PT hip fractures surgically treated with intramedullary devices. MATERIALS AND METHODS A total of 72 patients were included in this retrospective study. TAD values were radiographically analysed at a mean follow up of 13 months. This was correlated with limited functional status and rate of revision for implant failure or inability to achieve fracture union. Only 62 patients had adequate follow up to fracture union or definitive failure. RESULTS There were 36 intertrochanteric fractures and 26 subtrochanteric fractures. Overall, 5 patients (9.8%) went on to experience lag screw cut out. The average TAD of patients who did not cut-out was 18 mm compared to 38 mm for those who did (p=0.012). All patients who cut-out had IT fractures. CONCLUSION The percentage of cut-outs correlated clinically to both the severity of IT fractures and the TAD. Using a cut-off of 25 mm, there was a statistically significant difference in the incidence of lag screw cut-out (p<0.001). As in sliding hip screw, surgeons should strive for a TAD less than 25 mm when using IM devices in the treatment of PT hip fractures to help avoid lag screw cut-out.
Authors and Affiliations
Purushotham K, Nikil Sanaba Paramesh, Gaya B. T
Keywords
Related Articles
- EP ID EP214340
- DOI 10.18410/jebmh/2017/171
- Views 96
- Downloads 0
A CLINICAL STUDY OF THE CUTANEOUS MANIFESTATIONS OF LUPUS ERYTHEMATOSUS
BACKGROUND Lupus Erythematosus (LE) is a group of heterogenous autoimmune diseases with an array of manifestations ranging from cutaneous lesions to life-threatening systemic manifestations. Cutaneous manifestations are...
LOCAL CORTICOSTEROID INJECTION FOR TREATMENT OF DE QUERVAIN’S DISEASE
BACKGROUND De Quervain’s disease or stenosing tenosynovitis of first dorsal compartment of the wrist is common wrist pathology. Pain at radial site of wrist results from resisted gliding of the abductor pollicis longus a...
ROLE OF FIBEROPTIC BRONCHOSCOPY IN PATIENTS WITH SPUTUM SMEAR NEGATIVE FOR ACID FAST BACILLI AND CHEST XRAY SUGGESTIVE OF PULMONARY TUBERCULOSIS
AIMS: To study the role of fiberoptic bronchoscopy in patients with sputum smear negative for AFB and chest X-ray suggestive of pulmonary tuberculosis. SETTINGS AND DESIGN: After informed consent, 60 adult patients with...
PREDICTORS OF CORONARY SLOW FLOW OR NO REFLOW PHENOMENA AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION
BACKGROUND The treatment of acute myocardial infarction (AMI) is thought to restore antegrade blood flow in the infarct-related artery with percutaneous coronary interventions (PCI). The present study was undertaken to i...
ULTRASOUND GUIDED SELECTIVE NERVE BLOCKS IN THE MANAGEMENT OF HAND INJURY: A CASE REPORT
Regional anesthesia has proved to be very useful in ambulatory upper limb surgery. This technique along with ultra-sonogram guide has refined the whole concept of peripheral nerve blocks. Peripheral nerve blocks have pro...