• J Orthop Trauma · Jun 2013

    Comparative Study

    Does modern nail geometry affect positioning in the distal femur of elderly patients with hip fractures? A comparison of otherwise identical intramedullary nails with a 200 versus 150 cm radius of curvature.

    • Cory A Collinge and C P T Michael J Beltran.
    • Harris Methodist Fort Worth Hospital and John Peter Smith Orthopaedic Surgery Residency Program, Fort Worth, TX 76104, USA. ccollinge@msn.com
    • J Orthop Trauma. 2013 Jun 1;27(6):299-302.

    ObjectiveTo compare implant positioning in the distal femur between 2 cohorts of elderly patients treated for a hip fracture with a long 200- or 150-cm radius of curvature (ROC) cephalomedullary nail. We theorized that the 150-cm ROC nails would more closely approximate the femoral bow and result in fewer implant-related complications.DesignRetrospective Comparative Study.SettingSingle Level II Trauma Center.ParticipantsFifty-eight geriatric patients with a hip fracture (26 in 200-cm nail cohort and 32 in 150-cm nail cohort).InterventionLong cephalomedullary nailing using single hip fracture nail and instrumentation system (InterTAN) before and after transition from a 200- to 150-cm ROC long hip nail.Main Outcome MeasuresAnteroposterior position of distal nail tip on intraoperative lateral radiograph (where 0.50 indicates midaxial, perfectly central placement) and implant-related complications (anterior cortical abutment, perforation, or fracture).ResultsThe average position of nails with a 150-cm ROC was closer to the midaxial line of the distal femur compared with 200-cm nails (0.63 vs. 0.55, P = 0.02). Only 1 of 26 (3.8%) 200-cm ROC nails was placed at the midaxial line and none were posterior, whereas 9 of 32 (28%) 150-cm ROC nails were positioned at or posterior to this line (P = 0.006). Only 1 nail with a 150-cm ROC abutted the distal femur's anterior cortex compared with 3 in the 200-cm cohort-including one that caused a fracture.ConclusionsFemoral nails with a 150-cm ROC more closely approximate the femoral bow of geriatric hip fracture patients than 200-cm ROC nails, appearing less likely to cause complications such as anterior cortical abutment, perforation, or fracture.Level Of EvidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…