Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study
Abstract Background It is irresponsible if we disregard reduction quality to talk about cut-outs in intertrochanteric fractures (ITF) with internal fixation. The aim of this study is to analyze the risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable re...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05296-8 |
| _version_ | 1818022621687578624 |
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| author | Jian-wen Huang Xiao-sheng Gao Yun-fa Yang |
| author_facet | Jian-wen Huang Xiao-sheng Gao Yun-fa Yang |
| author_sort | Jian-wen Huang |
| collection | DOAJ |
| description | Abstract Background It is irresponsible if we disregard reduction quality to talk about cut-outs in intertrochanteric fractures (ITF) with internal fixation. The aim of this study is to analyze the risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. Methods In order to investigate the risk-factors for cut-outs in geriatric ITF after obtaining acceptable reduction, we retrospectively reviewed 367 patients who underwent cephalomedullary nail for ITF in our department between September 2016 and December 2021. Potential variables including demographic data and radiological parameters (namely the fracture type, Singh index, lateral wall fracture, cephalic nail position, Parker’s ratio index, tip-apex-distance (TAD), and calcar-referenced TAD (CalTAD)) were collected. Logistic regression analysis was performed to identify the significant risk factors for cut-outs. Results One hundred twenty-one patients were suitable for this study. Of the 121 cases, nine cases (7.4%) were observed with cut-out or pending cut-out. We found that Age (adjusted odds ratio (OR) 1.158, 95% confidence interval (CI) 1.016 to 1.318, p = 0.028), lateral wall fracture (adjusted OR 11.07, 95%CI 1.790 to 68.380, p = 0.01), and CalTAD (adjusted OR 1.277, 95%CI 1.005 to 1.622, p = 0.045) were independent risk-factors for cut-outs. Conclusions Age, lateral wall fracture and CalTAD are independent risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. In order to avoid cut-outs, an optimal CalTAD is necessary even obtaining acceptable reduction, especially in the over-aged patients with lateral wall fracture. |
| first_indexed | 2024-12-10T03:31:20Z |
| format | Article |
| id | doaj.art-79f25914d50f4c418d6d7e726e1f381a |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-10T03:31:20Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-79f25914d50f4c418d6d7e726e1f381a2022-12-22T02:03:48ZengBMCBMC Musculoskeletal Disorders1471-24742022-04-012311810.1186/s12891-022-05296-8Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control studyJian-wen Huang0Xiao-sheng Gao1Yun-fa Yang2Department of Orthopaedic Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital, School of Medicine, South China University of TechnologyDepartment of Orthopaedic Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital, School of Medicine, South China University of TechnologyDepartment of Orthopaedic Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital, School of Medicine, South China University of TechnologyAbstract Background It is irresponsible if we disregard reduction quality to talk about cut-outs in intertrochanteric fractures (ITF) with internal fixation. The aim of this study is to analyze the risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. Methods In order to investigate the risk-factors for cut-outs in geriatric ITF after obtaining acceptable reduction, we retrospectively reviewed 367 patients who underwent cephalomedullary nail for ITF in our department between September 2016 and December 2021. Potential variables including demographic data and radiological parameters (namely the fracture type, Singh index, lateral wall fracture, cephalic nail position, Parker’s ratio index, tip-apex-distance (TAD), and calcar-referenced TAD (CalTAD)) were collected. Logistic regression analysis was performed to identify the significant risk factors for cut-outs. Results One hundred twenty-one patients were suitable for this study. Of the 121 cases, nine cases (7.4%) were observed with cut-out or pending cut-out. We found that Age (adjusted odds ratio (OR) 1.158, 95% confidence interval (CI) 1.016 to 1.318, p = 0.028), lateral wall fracture (adjusted OR 11.07, 95%CI 1.790 to 68.380, p = 0.01), and CalTAD (adjusted OR 1.277, 95%CI 1.005 to 1.622, p = 0.045) were independent risk-factors for cut-outs. Conclusions Age, lateral wall fracture and CalTAD are independent risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. In order to avoid cut-outs, an optimal CalTAD is necessary even obtaining acceptable reduction, especially in the over-aged patients with lateral wall fracture.https://doi.org/10.1186/s12891-022-05296-8Cut-outIntertrochanteric FracturesReductionsCephalomedullary nailingThe elderly |
| spellingShingle | Jian-wen Huang Xiao-sheng Gao Yun-fa Yang Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study BMC Musculoskeletal Disorders Cut-out Intertrochanteric Fractures Reductions Cephalomedullary nailing The elderly |
| title | Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study |
| title_full | Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study |
| title_fullStr | Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study |
| title_full_unstemmed | Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study |
| title_short | Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case–control study |
| title_sort | risk factors for cut outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction a case control study |
| topic | Cut-out Intertrochanteric Fractures Reductions Cephalomedullary nailing The elderly |
| url | https://doi.org/10.1186/s12891-022-05296-8 |
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