Clinical implications of impingement of the anterior femoral cortex after cephalomedullary nailing

Peña, Omar R.; Gélvez, Amparo Gómez; Espinosa, Kristian A.

doi:10.1016/j.injury.2016.06.025

Cited by 8 publications

(2 citation statements)

References 23 publications

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“… 49 Anterior impingement has also been described in locked nails and although theoretically may be associated with nonunion and peri-implant fractures, it has not yet been proven. 50 , 51 , 52 …”

Section: Resultsmentioning

confidence: 99%

“…Little evidence is available comparing static and dynamic locking modes in unstable fracture patterns. Some authors advocate static mode to prevent fracture displacement and leg shortening, 3 , 36 , 41 , 43 , 51 while others prefer distal locking in dynamic mode arguing that it reduces distal cortical hypertrophy, thigh pain, and fracture risk and allows compression of the fracture with load-bearing. 6 , 32 , 34 , 35 , 38 , 46 , 47 …”

Section: Discussionmentioning

confidence: 99%

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Distal interlocking for short trochanteric nails: static, dynamic or no locking? Review of the literature and decision algorithm

et al. 2020

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Pertrochanteric hip fractures are among the most common and the use of short cephalomedullary nails as the treatment of choice is increasing. A systematic review regarding distal locking options for short cephalomedullary nails was undertaken using Medline/PubMed®, Embase® and Cochrane Library® in order to evaluate current indications, associated complications and to provide treatment recommendations. The results seem to support the use of distal static locking for unstable fractures, dynamic locking for length stable/rotational unstable fractures and no locking for stable fractures. Complications associated with distal locking include iatrogenic fractures, thigh pain, delayed union and nonunion, implant failure, screw loosening and breaking, drill bit breaking, soft tissue irritation, femoral artery branch injury, intramuscular haematoma and compartment syndrome. It is also associated with longer operative time and radiation exposure. In unlocked constructs, dorsomedial comminution and nail/medullary canal mismatch contribute to peri-implant fractures. Anterior cortical impingement is associated with cut-out and nonunion. Most studies comparing distally locked and unlocked nails report a short follow-up. Distal locking mode should be based on the fracture’s stability. Cite this article: EFORT Open Rev 2020;5:421-429. DOI: 10.1302/2058-5241.5.190045

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