The Cost and Consequences of Failed Osteosynthesis of Intertrochanteric Femur Fractures: A Matched Cohort Study

Özdemir, Erdi; Okkaoğlu, Mustafa Caner; Evren, Ali Teoman; Yaradılmış, Yüksel Uğur; Ateş, Ahmet Hakan; Altay, Murat

doi:10.1007/s43465-020-00322-0

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…[ 5 - 7 ] Well-established risk factors for implant failure of CMN in the treatment of ITFF are increased tip-apex distance, unstable fractures, and inadequate reduction. [ 8 , 9 ] Although risk factors for implant failure have been extensively studied for CMNs in the treatment of ITFFs,[ 10 ] little focus has been given toward for the distal nail diameter.…”

Section: Introductionmentioning

confidence: 99%

What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?

Ergişi

Özdemir²,

Korkmazer³

et al. 2022

Jt Dis Relat Surg

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Hip fractures have become an important public health problem all over the world due to increased life expectancy. The main causes of hip fractures in the elderly are higher incidence of falls and osteoporosis. Hip fractures have many negative impacts on individuals due to their morbidity and mortality, as well as negative socioeconomic effects on society. [1,2] Intertrochanteric femur fractures (ITFFs) constitute about 50% of hip fractures. [3] Cephalomedullary nailing (CMN) has become the primary treatment method for ITFF in many trauma centers in the past decade due to its biomechanical advantages such as allowing mobilization by weight-bearing in the early postoperative period, and being more reliable and less invasive than other surgical options. [4] Objectives: The aim of this study was to investigate the effect of distal nail diameter in the treatment of geriatric intertrochanteric femur fractures (ITFFs).Patients and methods: Between January 2017 and January 2021, a total of 91 patients (34 males, 57 females; mean age: 80.6±7.8 years; range, 65 to 96 years) who had osteosynthesis due to an ITFF with a short cephalomedullary nail (CMN) were retrospectively analyzed. The patients were divided into two groups: Group 1 (n=18) included patients with a distal nail diameter of ≤10 mm and Group 2 (n=73) included patients with a distal nail diameter of >10 mm. Patients' age, sex, fracture type according to AO classification, intramedullary femoral canal diameter, canal fit ratio, operation duration, reduction quality, the distal diameter of the CMN, and complications were evaluated.Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the mean age, sex, fracture type, mean intramedullary canal diameter, reduction quality, and implant failure (p>0.05). The mean operation duration was significantly shorter in Group 2 (112.9±39.9 min) compared to Group 1 (128.8±36.4 min) (p=0.048). A total of three intraoperative peri-implant fractures occurred which included one 9 mm nail, one 12 mm nail, and one 14 mm nail. Conclusion:Our study results suggest that there is no advantage of using a >10-mm CMN in the treatment of geriatric ITFFs in terms of reducing the implant failure rate. However, the utility of a >10-mm CMN can reduce the operation duration.

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Section: Introductionmentioning

confidence: 99%

What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?

Ergişi

Özdemir²,

Korkmazer³

et al. 2022

Jt Dis Relat Surg

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show abstract

“…The constant increase in the number of elderly and senile people in the world is accompanied by an increase in cases of osteoporotic fractures in the area of the hip joint [1]. About 45% of them are fractures of the trochanteric zone [2,3]. Due to the presence of concomitant diseases in patients of this age category, the treatment of trochanteric fractures represents a complex medical, social and economic problem.…”

mentioning

confidence: 99%

“…However, with unstable fractures (31-A A2.2, 31-A2.3, 31-A3.3 according to the OA classification) after osteosynthesis, a high level of complications is observed (from 0.5 to 56%) depending on the type of fracture, patients' condition, quality of the reposition and fixation. According to research data, primary hemiarthroplasty with unstable pertrochanteric fractures provides more guarantees of early restoration of function of the damaged limb and, therefore, is used as an alternative to osteosynthesis [2,5]. However, if osteoporosis and a destroyed proximal metaphysis is present, the implantation of the femoral component requires careful mechanical evaluation to ensure the primary stability of the femoral component and the entire artificial hip joint.…”

mentioning

confidence: 99%

Primary Arthroplasty of Intertrochanteric Fractures From the Point of View of Biomechanical Research

Kanziuba,

Popurkanich

2023

Ricerche Scientifiche E Metodi Della Loro Realizzazione: Esperienza Mondiale E Realtà Domestiche

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Salvage hip replacement after cut-out failure of cephalomedullary nail fixation for proximal femur fractures: a case series describing the technique and results

Corró

Óleo-Taltavull

Teixidor-Serra

et al. 2022

International Orthopaedics (SICOT)

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The Cost and Consequences of Failed Osteosynthesis of Intertrochanteric Femur Fractures: A Matched Cohort Study

Cited by 4 publications

References 30 publications

What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?

What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?

Primary Arthroplasty of Intertrochanteric Fractures From the Point of View of Biomechanical Research

Salvage hip replacement after cut-out failure of cephalomedullary nail fixation for proximal femur fractures: a case series describing the technique and results

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