Treatment of intertrochanteric fractures using cephalomedullary nail: One or two cephalic screws?
To determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with single cephalic screw fixation and the other with dual-screw fixation using a lag screw and an anti-rotation screw. A retrospective study from a cohort of p...
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| Published in: | Injury Vol. 54 Suppl 6; p. 110625 |
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01-11-2023
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| Abstract | To determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with single cephalic screw fixation and the other with dual-screw fixation using a lag screw and an anti-rotation screw.
A retrospective study from a cohort of patients was conducted between January 2017 and August 2019 in patients with intertrochanteric fractures treated with osteosynthesis using CMN.
One hundred ninety-six patients with intertrochanteric fractures who met the inclusion criteria were recruited. The median age was 81 years [interquartile range (IQR) 12]. Seventy-six percent had fractures classified as Orthopaedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen (OTA/AO) 31A2. Twenty-one mechanical complications occurred, 8.7% (17) was cut-out with a single cephalic screw CMN and 2% (4) was Z-effect with a dual-screw CMN non-integrated. The median tip-apex distance (TAD) was 19.4 mm (IQR 10.8) in patients who experienced cut-out and 19 mm (IQR 10) in those who experienced Z-effect. The median time to cut-out occurrence was 39,5 days (IQR 47,5), while the median time to Z-effect was 90 days (IQR 86).
The incidence of osteosynthesis failure using CMN is more frequent in patients treated with a single cephalic screw CMN.
Therapeutic, Level III. |
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| AbstractList | To determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with single cephalic screw fixation and the other with dual-screw fixation using a lag screw and an anti-rotation screw.
A retrospective study from a cohort of patients was conducted between January 2017 and August 2019 in patients with intertrochanteric fractures treated with osteosynthesis using CMN.
One hundred ninety-six patients with intertrochanteric fractures who met the inclusion criteria were recruited. The median age was 81 years [interquartile range (IQR) 12]. Seventy-six percent had fractures classified as Orthopaedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen (OTA/AO) 31A2. Twenty-one mechanical complications occurred, 8.7% (17) was cut-out with a single cephalic screw CMN and 2% (4) was Z-effect with a dual-screw CMN non-integrated. The median tip-apex distance (TAD) was 19.4 mm (IQR 10.8) in patients who experienced cut-out and 19 mm (IQR 10) in those who experienced Z-effect. The median time to cut-out occurrence was 39,5 days (IQR 47,5), while the median time to Z-effect was 90 days (IQR 86).
The incidence of osteosynthesis failure using CMN is more frequent in patients treated with a single cephalic screw CMN.
Therapeutic, Level III. OBJECTIVESTo determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with single cephalic screw fixation and the other with dual-screw fixation using a lag screw and an anti-rotation screw.METHODSA retrospective study from a cohort of patients was conducted between January 2017 and August 2019 in patients with intertrochanteric fractures treated with osteosynthesis using CMN.RESULTSOne hundred ninety-six patients with intertrochanteric fractures who met the inclusion criteria were recruited. The median age was 81 years [interquartile range (IQR) 12]. Seventy-six percent had fractures classified as Orthopaedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen (OTA/AO) 31A2. Twenty-one mechanical complications occurred, 8.7% (17) was cut-out with a single cephalic screw CMN and 2% (4) was Z-effect with a dual-screw CMN non-integrated. The median tip-apex distance (TAD) was 19.4 mm (IQR 10.8) in patients who experienced cut-out and 19 mm (IQR 10) in those who experienced Z-effect. The median time to cut-out occurrence was 39,5 days (IQR 47,5), while the median time to Z-effect was 90 days (IQR 86).CONCLUSIONSThe incidence of osteosynthesis failure using CMN is more frequent in patients treated with a single cephalic screw CMN.LEVEL OF EVIDENCETherapeutic, Level III. |
| ArticleNumber | 110625 |
| Author | Muñoz-Medina, Sofía Elizabeth Lara-Garavito, Andrés Mauricio Cuesta-Montoya, Juan Sebastián Gómez-Ramírez, Jairo Fernando Rincón-Hoyos, Jairo Alonso Castro-Dangond, Alfredo José |
| Author_xml | – sequence: 1 givenname: Jairo Alonso surname: Rincón-Hoyos fullname: Rincón-Hoyos, Jairo Alonso organization: Hip and orthopedic trauma surgeon, Clínica Universitaria Colombia, Carrera 21 No. 127D-39, Bogotá, 110121 Colombia – sequence: 2 givenname: Jairo Fernando surname: Gómez-Ramírez fullname: Gómez-Ramírez, Jairo Fernando organization: Chief of Orthopedic Trauma Service, Clínica Universitaria Colombia, Bogotá, Colombia – sequence: 3 givenname: Juan Sebastián surname: Cuesta-Montoya fullname: Cuesta-Montoya, Juan Sebastián organization: Orthopedic trauma surgeon, Clínica Universitaria Colombia, Bogotá, Colombia – sequence: 4 givenname: Andrés Mauricio surname: Lara-Garavito fullname: Lara-Garavito, Andrés Mauricio organization: Fellowship-trained orthopedic trauma surgeon, Clínica Universitaria Colombia, Bogotá, Colombia – sequence: 5 givenname: Sofía Elizabeth surname: Muñoz-Medina fullname: Muñoz-Medina, Sofía Elizabeth organization: MD, Research Unit, Fundación Universitaria Sanitas, Bogotá, Colombia – sequence: 6 givenname: Alfredo José surname: Castro-Dangond fullname: Castro-Dangond, Alfredo José organization: Orthopedic trauma surgeon, Fundación Universitaria Sanitas, Clínica Universitaria Colombia, Bogotá, Colombia |
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| Cites_doi | 10.1016/j.jcma.2017.04.007 10.1302/0301-620X.96B8.33644 10.1016/j.injury.2010.08.009 10.1186/1749-799X-5-9 10.1007/s00776-015-0750-4 10.1097/BOT.0000000000000552 10.1186/s13018-016-0344-7 10.1007/s00590-016-1757-z 10.2106/00004623-195941080-00003 10.1007/s00264-013-2120-1 10.1302/0301-620X.99B1.BJJ-2016-0134.R1 10.1016/j.injury.2015.08.007 10.2174/1874325001408010060 10.1302/2046-3758.68.BJR-2016-0299.R1 10.1186/s13000-014-0191-y 10.1016/j.injury.2016.11.018 10.1007/s00402-017-2863-z 10.1016/j.injury.2017.06.020 |
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| References | Yu (10.1016/j.injury.2023.02.008_bib0011) 2016; 11 Buyukdogan (10.1016/j.injury.2023.02.008_bib0002) 2017; 48 Winnock de Grave (10.1016/j.injury.2023.02.008_bib0016) 2012; 78 Santoni (10.1016/j.injury.2023.02.008_bib0012) 2016; 30 Sambandam (10.1016/j.injury.2023.02.008_bib0007) 2016; 26 Seyhan (10.1016/j.injury.2023.02.008_bib0017) 2015; 20 Yam (10.1016/j.injury.2023.02.008_bib0019) 2017; 48 Socci (10.1016/j.injury.2023.02.008_bib0006) 2017; 99-B Tsai (10.1016/j.injury.2023.02.008_bib0004) 2017; 80 Kashigar (10.1016/j.injury.2023.02.008_bib0005) 2014; 96-B Kouzelis (10.1016/j.injury.2023.02.008_bib0020) 2014; 8 Cleveland (10.1016/j.injury.2023.02.008_bib0008) 1959; 41A Kanakaris (10.1016/j.injury.2023.02.008_bib0021) 2015; 46 Zehir (10.1016/j.injury.2023.02.008_bib0009) 2015; 21 Cuervas-Mons (10.1016/j.injury.2023.02.008_bib0018) 2014; 58 Caruso (10.1016/j.injury.2023.02.008_bib0001) 2017; 6 Murena (10.1016/j.injury.2023.02.008_bib0003) 2018; 138 Lobo-Escolar (10.1016/j.injury.2023.02.008_bib0013) 2010; 41 Makridis (10.1016/j.injury.2023.02.008_bib0015) 2010; 5 Huang (10.1016/j.injury.2023.02.008_bib0014) 2013; 37 Wu (10.1016/j.injury.2023.02.008_bib0010) 2014; 9 |
| References_xml | – volume: 80 start-page: 587 issue: 9 year: 2017 ident: 10.1016/j.injury.2023.02.008_bib0004 article-title: Risk factors for cut-out failure of Gamma3 nails in treating unstable intertrochanteric fractures: an analysis of 176 patients publication-title: J Chin Med Assoc doi: 10.1016/j.jcma.2017.04.007 contributor: fullname: Tsai – volume: 96-B start-page: 1029 issue: 8 year: 2014 ident: 10.1016/j.injury.2023.02.008_bib0005 article-title: Predictors of failure for cephalomedullary nailing of proximal femoral fractures publication-title: Bone Joint J doi: 10.1302/0301-620X.96B8.33644 contributor: fullname: Kashigar – volume: 41 start-page: 1312 issue: 12 year: 2010 ident: 10.1016/j.injury.2023.02.008_bib0013 article-title: Predictive factors for cutting-out in femoral intramedullary nailing publication-title: Injury doi: 10.1016/j.injury.2010.08.009 contributor: fullname: Lobo-Escolar – volume: 5 start-page: 9 year: 2010 ident: 10.1016/j.injury.2023.02.008_bib0015 article-title: Comparing two intramedullary devices for treating trochanteric fractures: a prospective study publication-title: J Orthop Surg Res doi: 10.1186/1749-799X-5-9 contributor: fullname: Makridis – volume: 20 start-page: 1053 issue: 6 year: 2015 ident: 10.1016/j.injury.2023.02.008_bib0017 article-title: Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study publication-title: J Orthop Sci doi: 10.1007/s00776-015-0750-4 contributor: fullname: Seyhan – volume: 30 start-page: 164 issue: 4 year: 2016 ident: 10.1016/j.injury.2023.02.008_bib0012 article-title: Comparison of femoral head rotation and varus collapse between a single lag screw and integrated dual screw intertrochanteric hip fracture fixation device using a cadaveric hemi-pelvis biomechanical model publication-title: J Orthop Trauma doi: 10.1097/BOT.0000000000000552 contributor: fullname: Santoni – volume: 11 start-page: 10 year: 2016 ident: 10.1016/j.injury.2023.02.008_bib0011 article-title: A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly publication-title: J Orthop Surg Res doi: 10.1186/s13018-016-0344-7 contributor: fullname: Yu – volume: 26 issue: 4 year: 2016 ident: 10.1016/j.injury.2023.02.008_bib0007 article-title: Intertrochanteric fractures: a review of fixation methods publication-title: Eur J Orthop Surg Traumatol doi: 10.1007/s00590-016-1757-z contributor: fullname: Sambandam – volume: 41A start-page: 1399 year: 1959 ident: 10.1016/j.injury.2023.02.008_bib0008 article-title: A ten-year analysis of intertrochanteric fractures of the femur publication-title: J Bone Joint Surg Am doi: 10.2106/00004623-195941080-00003 contributor: fullname: Cleveland – volume: 37 start-page: 2465 issue: 12 year: 2013 ident: 10.1016/j.injury.2023.02.008_bib0014 article-title: A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures publication-title: Int Orthop doi: 10.1007/s00264-013-2120-1 contributor: fullname: Huang – volume: 99-B start-page: 128 issue: 1 year: 2017 ident: 10.1016/j.injury.2023.02.008_bib0006 article-title: Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations publication-title: Bone Joint J doi: 10.1302/0301-620X.99B1.BJJ-2016-0134.R1 contributor: fullname: Socci – volume: 46 start-page: 12 issue: Suppl 5 year: 2015 ident: 10.1016/j.injury.2023.02.008_bib0021 article-title: Preliminary results of the treatment of proximal femoral fractures with the AFFIXUS nail publication-title: Injury doi: 10.1016/j.injury.2015.08.007 contributor: fullname: Kanakaris – volume: 58 issue: 6 year: 2014 ident: 10.1016/j.injury.2023.02.008_bib0018 article-title: Desmontaje por efecto cut-out en el enclavado de fracturas pertrocantéreas de fémur: ¿cuál es el tratamiento de rescate de elección? [Removal due to cut-off effect in pertrochanteric femoral fractures. What is the rescue treatment of choice?] publication-title: Rev Esp Cir Ortop Traumatol contributor: fullname: Cuervas-Mons – volume: 8 start-page: 60 year: 2014 ident: 10.1016/j.injury.2023.02.008_bib0020 article-title: Double axis cephalocondylic fixation of stable and unstable intertrochanteric fractures: early results in 60 Cases with the veronail system publication-title: Open Orthop J doi: 10.2174/1874325001408010060 contributor: fullname: Kouzelis – volume: 6 start-page: 481 issue: 8 year: 2017 ident: 10.1016/j.injury.2023.02.008_bib0001 article-title: A six-year retrospective analysis of cut-out risk predictors in cephalomedullary nailing for pertrochanteric fractures: can the tip-apex distance (TAD) still be considered the best parameter? publication-title: Bone Joint Res doi: 10.1302/2046-3758.68.BJR-2016-0299.R1 contributor: fullname: Caruso – volume: 9 start-page: 191 year: 2014 ident: 10.1016/j.injury.2023.02.008_bib0010 article-title: InterTan nail versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures publication-title: Diagn Pathol doi: 10.1186/s13000-014-0191-y contributor: fullname: Wu – volume: 78 start-page: 192 issue: 2 year: 2012 ident: 10.1016/j.injury.2023.02.008_bib0016 article-title: Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs. A prospective randomised clinical trial publication-title: Acta Orthop Belg contributor: fullname: Winnock de Grave – volume: 48 start-page: 414 issue: 2 year: 2017 ident: 10.1016/j.injury.2023.02.008_bib0002 article-title: Risk factors for cut-out of double lag screw fixation in proximal femoral fractures publication-title: Injury doi: 10.1016/j.injury.2016.11.018 contributor: fullname: Buyukdogan – volume: 21 start-page: 469 issue: 6 year: 2015 ident: 10.1016/j.injury.2023.02.008_bib0009 article-title: Comparison of clinical outcomes with three different intramedullary nailing devices in treatment of unstable trochanteric fractures publication-title: Ulus Travma Acil Cerrahi Derg contributor: fullname: Zehir – volume: 138 start-page: 351 issue: 3 year: 2018 ident: 10.1016/j.injury.2023.02.008_bib0003 article-title: Predictors of cut-out after cephalomedullary nail fixation of pertrochanteric fractures: a retrospective study of 813 patients publication-title: Arch Orthop Trauma Surg doi: 10.1007/s00402-017-2863-z contributor: fullname: Murena – volume: 48 start-page: 1843 issue: 8 year: 2017 ident: 10.1016/j.injury.2023.02.008_bib0019 article-title: Rewriting the tip apex distance for the proximal femoral nail anti-rotation publication-title: Injury doi: 10.1016/j.injury.2017.06.020 contributor: fullname: Yam |
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| Snippet | To determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with single cephalic... OBJECTIVESTo determine the incidence of cut-out, cut-in, cut-through, Z-effect, and reverse Z-effect in two cephalomedullary nail (CMN) systems: one with... |
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| SubjectTerms | Aged, 80 and over Bone Nails - adverse effects Bone Screws - adverse effects Fracture Fixation, Intramedullary - adverse effects Hip Fractures - diagnostic imaging Hip Fractures - etiology Hip Fractures - surgery Humans Retrospective Studies Treatment Outcome |
| Title | Treatment of intertrochanteric fractures using cephalomedullary nail: One or two cephalic screws? |
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