Clinical results of trochanteric fractures treated with the TARGON® proximal femur intramedullary nailing fixation system

Postoperative stability on lateral radiographs in the surgical treatment of pertrochanteric hip fractures

“…Ikuta [10] performed a study based on lateral radiographs at the time of impaction between the proximal head and neck fragment and the distal femoral shaft fragment. Cases in the study were classiWed into three groups based on the direction of displacement seen in the lateral radiographs [10,22]. Ikuta noted that excessive sliding could occur if head and neck fragments were posteriorly displaced; however, the study did not include statistical analysis.…”

Direct reduction may need to be considered to avoid postoperative subtype P in patients with an unstable trochanteric fracture: a retrospective study using a multivariate analysis

“…Ninety-seven percent of patients obtained an optimal reduction in the postoperative AP view, as described previously [7]. Regarding the insertion of a lag screw in the femoral head, 75 of the 136 patients (55 %) obtained the optimal position [4].…”

“…Regarding the position of the lag screw in the femoral head, the femoral head was divided into six areas as a grid, which included superior and inferior areas (S, I) in the AP view, and anterior, middle and posterior areas (A, M, P) in the lateral view (Fig. 2C) [4]. The tip-apex distance (TAD) was measured according to the method described by Baumgaertner et al [11].…”

“…Early surgical treatment is advocated in the majority of these patients to reduce the complications associated with long-term immobilization [1][2][3]. Intramedullary nails are frequently used in their surgical treatment, which produces strong internal fixation due to their short lever arm, and thus allows for early weight bearing even for elderly patients with osteoporosis [4].…”

“…Ikuta first focused on the correlation between the fracture reduction in the lateral view of radiographs and the postoperative outcome [8]. He concluded that the posterior displacement of the head and neck fragment (subtype P = posterior) had the potential to slide excessively because most of the impaction during sliding would occur on the fragile posterior cortex [4,8,9]. Recently, Tsukada et al [9] reported that excessive sliding occurs following the surgical treatment for peritrochanteric fractures with displacement of postoperative subtype P. However, to the best of our knowledge, there have been no reports that have assessed the factors that may correlate with the postoperative subtype N. Kozono Á S. Ikemura (&) Á A. Yamashita Á T. Harada Á T. Watanabe Á K. Shirasawa Investigation performed at the Department of Orthopaedic Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-cho, Shimonoseki 750-8520, Japan e-mail: saikemura@gmail.com on the lateral view of radiographs.…”