Key result
Treatment of intertrochanteric fractures with a proximal femoral nail resulted in a mean Harris hip score of 90.35, with a tip apex distance >25 mm predicting worse functional outcomes and screw cut-out.
Why the study?
Surgical treatment of hip fractures allows stable fixation and early weight bearing, but mechanical failures still occur despite the development of many devices.
Does proximal femoral nail fixation result in favorable functional and radiological outcomes in patients with intertrochanteric fractures?
Observational (n=46)
No
Does proximal femoral nail fixation result in favorable functional and radiological outcomes in patients with intertrochanteric fractures?
In patients with intertrochanteric fractures treated with a proximal femoral nail, a tip apex distance greater than 25 mm is associated with worse functional and radiological outcomes, including screw cut-out.
Answers are grounded in this paper and cite their sources.
Functional and radiological outcomes after intertrochanteric fracture fixation described; leaves open optimal device selection in geriatric patients.
Background: Hip fracture is one of the most invalidating diseases affecting geriatric populations and in fall related fractures, they lead to most severe morbidity and mortality. Their surgical treatment allows stable fracture fixation which allows the early weight bearing. Many devices have been developed, yet mechanical failures still occur. The aim of this study was to assess the functional and radiological outcomes of intertrochanteric fractures treated with proximal femoral nail. Methods: 46 patients with intertrochanteric fractures fixed with proximal femoral nail were assessed. Functional outcome was measured by Harris hip score (HHS) and lower extremity functional scale (LEFS) and radiological outcome was measured by tip apex distance (TAD), any changes in neck shaft angle, neck length and the offset as compared to uninjured hip. Results: The tip apex distance on the postoperative X-ray was found to be 22.02±2.499 mm, change in the neck length as compared to the uninjured hip was found to be 1.507±1.1808 and change in the offset and neck shaft angle was 1.470±1.0126 and -1.602±1.5992 respectively. The LEFS was found to be 70.63±6.584 whereas the HHS was found to be 90.35±7.593 Conclusions: With the increase in TAD the functional and radiological outcome worsens. It was also seen that the cutoff of 25 mm stands true in predicting the outcome of the patients with PFN in intertrochanteric fractures. Hence, the TAD should be routinely measured and if found more than 25 mm then proper precautions like delayed weight bearing may be advised.
No takes yet. Share an insight, caveat, or question.
Chopra et al. (2020) conducted an observational in Intertrochanteric fractures (n=46). Proximal femoral nail was evaluated on Functional (Harris hip score, LEFS) and radiological (tip apex distance) outcomes. Treatment of intertrochanteric fractures with a proximal femoral nail resulted in a mean Harris hip score of 90.35, with a tip apex distance >25 mm predicting worse functional outcomes and screw cut-out.
Synapse has enriched 10 related papers. Consider them for comparative context: