Late postoperative analysis of the tip-apex distance (TAD) in pertrochanteric fractures: is there an accommodation of the implant within the bone?

This study measured the tip-apex distance (TAD) values in the immediate postoperative period and following weight-bearing and fracture impaction in patients undergoing osteosynthesis with dynamic hip screw and cephalomedullary nail. To correlate the Baumgaertner index in the immediate postoperative...

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Bibliographic Details
Published in:Injury 2017-10, Vol.48, p.S54-S56
Main Authors: Aihara, Leandro Jun, Nanni, Rafael Augusto, Carvalho, Marina Sousa, Zamboni, Caio, Durigan, Jorge R., Hungria Neto, José S., Mercadante, Marcelo T., Christian, Ralph W., Hungria, José O.S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomechanical Phenomena
Bone Nails
Bone Screws
Female
Femur Head - anatomy & histology
Femur Head - surgery
Fracture Fixation, Intramedullary
Hip Fractures - physiopathology
Hip Fractures - surgery
Humans
Intramedullary nailing
Male
Middle Aged
Pertrochanteric fractures
Postoperative Period
Retrospective Studies
Sliding hip screw
Tip-apex distance
Treatment Outcome
Weight-Bearing - physiology
Young Adult
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Summary:This study measured the tip-apex distance (TAD) values in the immediate postoperative period and following weight-bearing and fracture impaction in patients undergoing osteosynthesis with dynamic hip screw and cephalomedullary nail. To correlate the Baumgaertner index in the immediate postoperative period with values obtained after impaction of the fracture with the accommodation of the cephalic implant in the femoral head. Radiographic TAD measurements were taken with AGFA-VIEW® of 82 patients with a mean age of 72 years with pertrochanteric fractures who were operated on and the fracture fixed with DHS- Synthes®, TFN-Synthes®, or Gamma Nail III-Stryker® in the immediate postoperative period, and following weight-bearing and fracture impaction (mean 3–8 weeks after surgery). The overall average TAD decreased from 20.3mm to 18.2mm. Regardless of the instability of the fracture, the age of the patient or the implant used, TAD decreased between the immediate postoperative period and following fracture impaction. The osteosynthesis of pertrochanteric fractures was associated with important accommodation of the cephalic implant in the femoral head with decreased TAD values after weight-bearing.
ISSN:0020-1383
1879-0267
DOI:10.1016/S0020-1383(17)30776-3