Correlation between femoral offset loss and dynamic hip screw cut-out complications after pertrochanteric fractures: a case–control study

Boukebous, Baptiste; Guillon, P.; Vandenbussche, E.; Rousseau, M.-A.

doi:10.1007/s00590-018-2204-0

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…In particular, the failure incidence can reach 51.4% in unstable intertrochanteric hip fractures ( Memon et al, 2021 ). Failure patterns include femoral head varus collapse, medialization of distal fragment and screw cut-out of the lag screw, which always result in a revision surgery ( Boukebous et al, 2018 ; Taheriazam and Saeidinia, 2019 ; Memon et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of the undercut thread design versus conventional buttress thread for the lag screw of the dynamic hip screw system

Liu

Feng²,

Zheng³

et al. 2022

Front. Bioeng. Biotechnol.

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Objective: To compare the fixation stability of the lag screw with a undercut thread design for the dynamic hip screw (DHS) system versus the lag screw with the conventional buttress thread.Methods: The lag screws with the undercut thread (a flat crest feature, a tip-facing undercut feature) and buttress thread were both manufactured. Fixation stability was investigated using cyclic compressive biomechanical testing on custom osteoporotic femoral head sawbone. The forces required for the same vertical displacement in the two types of lag screw were collected to evaluate the resistance to migration. Varus angle was measured on X-ray images to assess the ability in preventing varus collapse. Finite element analysis (FEA) was performed to analyze the stress and strain distribution at the bone-screw interface of the two types of lag screws.Results: The biomechanical test demonstrated that the force required to achieve the same vertical displacement of the lag screw with the undercut thread was significantly larger than the lag screw with conventional buttress thread (p < 0.05). The average varus angles generated by the undercut and buttress threads were 3.38 ± 0.51° and 5.76 ± 0.38°, respectively (p < 0.05). The FEA revealed that the region of high-stress concentration in the bone surrounding the undercut thread was smaller than that surrounding the buttress thread.Conclusion: The proposed DHS system lag screw with the undercut thread had higher migration resistance and superior fixation stability than the lag screw with the conventional buttress thread.

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Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of the undercut thread design versus conventional buttress thread for the lag screw of the dynamic hip screw system

Liu

Feng²,

Zheng³

et al. 2022

Front. Bioeng. Biotechnol.

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show abstract

“…In case of treatment failure, both the cost and these rates increase furtherly. (3)(4)(5)(6) It has been reported that the incidence of dynamic hip screw cut-out rate varies between 1% and 17% (7), plus the rate of cutting development after using intramedullary systems is 8%. (8) If treatment failure was prevented, these undesirable results for both the patient and the health system could occur less frequently.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Cut-Out after Fixation of Intertrochanteric Fractures with Two Cephalocervical Screwed Proximal Femur Nails

2021

GMJ

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Objective: To identify the factors of predicting cut-out development about implant position after fixation of proximal femoral fractures with two cephalocervical screwed femoral nails and to calculate the position-related failure risk. Methods: Retrospective analysis of clinical and radiographic data were performed on hospital records and 20 cases with implant cut-out were included in the study group. 31 cases from a similar epidemiological group who completed the second year without failure were included as a control group. Tip-apex distance (TADAP-TADL), calcar tip apex distance (CalTAD) were measured using radiographs, and Parker ratio was calculated for anteroposterior (ParkerAP) and lateral (ParkerLat) views. Advanced analysis was performed for each statistically significant variable to determine the cut-off point of the predictors for implant cut-out. Results: TADAP-L (p:<0.001), CalTAD (p:0.001) and ParkerLat ratio (p:0.001) calculated were found to have prognostic significance to estimate implant cutout. ParkerLat was found to be the most significant to estimate implant cut-out (p:0.001). The risk of implant cut-out development increased by 7.3 fold in TADAP, 5.7 in TADLat, and 8.6 in CalTAD, and the greatest risk was calculated in ParkerLat, and this increase was 11.5 fold (Cut-off:≥0.58, p:<0,001) Conclusion: Current study confirmed the significant relationship between implant cut-out and inadequate TAD and ParkerLat. The importance of predictors identified to prevent the development of this phenomenon has been demonstrated in this study for two cephalocervical screwed proximal femur nails. It has been shown that the central positioning of the proximal screw inserted while providing osteosynthesis in both anterior-posterior and lateral views was important in preventing cut-out development.

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Femoral offset loss and internal arch restoration defect are correlated with intramedullary nail cut-out complications after pertrochanteric fractures: a case–control study

Boukebous¹,

Flouzat-Lachaniette²,

Donadio³

et al. 2019

Eur J Orthop Surg Traumatol

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Correlation between femoral offset loss and dynamic hip screw cut-out complications after pertrochanteric fractures: a case–control study

Cited by 5 publications

References 21 publications

Biomechanical comparison of the undercut thread design versus conventional buttress thread for the lag screw of the dynamic hip screw system

Biomechanical comparison of the undercut thread design versus conventional buttress thread for the lag screw of the dynamic hip screw system

Predictors of Cut-Out after Fixation of Intertrochanteric Fractures with Two Cephalocervical Screwed Proximal Femur Nails

Femoral offset loss and internal arch restoration defect are correlated with intramedullary nail cut-out complications after pertrochanteric fractures: a case–control study

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