Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA)
Abstract Background The incidence of intertrochanteric hip fracture is expected to increase as the global population ages. It is one of the most important causes of mortality and morbidities in the geriatric population. The incidence of reverse oblique and transverse intertrochanteric (AO/OTA 31-A3)...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1414-4 |
| _version_ | 1811184157780344832 |
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| author | Youliang Hao Zhishan Zhang Fang Zhou Hongquan Ji Yun Tian Yan Guo Yang Lv Zhongwei Yang Guojin Hou |
| author_facet | Youliang Hao Zhishan Zhang Fang Zhou Hongquan Ji Yun Tian Yan Guo Yang Lv Zhongwei Yang Guojin Hou |
| author_sort | Youliang Hao |
| collection | DOAJ |
| description | Abstract Background The incidence of intertrochanteric hip fracture is expected to increase as the global population ages. It is one of the most important causes of mortality and morbidities in the geriatric population. The incidence of reverse oblique and transverse intertrochanteric (AO/OTA 31-A3) fractures is relatively low; however, the incidence of implant failure in AO/OTA 31-A3 fractures is relatively high compared with that in AO/OTA 31-A1 and A2 fractures. To date, the risk factors for implant failure in AO/OTA 31-A3 fractures treated with proximal femoral nail antirotation (PFNA) have remained ambiguous. The purpose of this study was to identify the predictive factors of implant failure in AO/OTA 31-A3 fractures treated with PFNA. Methods The data of all patients who underwent surgery for trochanteric fractures at our institution between January 2006 and February 2018 were retrospectively reviewed. All AO/OTA 31-A3 fractures treated with PFNA were included. Logistic regression analysis of potential predictors of implant failure was performed. Potential predictors included age, sex, body mass index, fracture type, reduction method, status of posteromedial support and lateral femoral wall, reduction quality, tip-apex distance and position of the helical blade in the femoral head. Results One hundred four (9.3%) patients with AO/OTA 31-A3 fractures were identified. Forty-five patients with AO/OTA 31-A3 fractures treated with PFNA were suitable for our study. Overall, implant failure occurred in six (13.3%) of forty-five patients. Multivariate analysis identified poor reduction quality (OR, 28.70; 95% CI, 1.91–431.88; p = 0.015) and loss of posteromedial support (OR, 18.98; 95% CI, 1.40–257.08; p = 0.027) as factors associated with implant failure. Conclusions Poor reduction quality and loss of posteromedial support are predictors of implant failure in reverse oblique and transverse intertrochanteric fractures treated with PFNA. |
| first_indexed | 2024-04-11T13:08:29Z |
| format | Article |
| id | doaj.art-9a0132217bb4487492671502e00d2cf2 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:08:29Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-9a0132217bb4487492671502e00d2cf22022-12-22T04:22:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-11-011411810.1186/s13018-019-1414-4Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA)Youliang Hao0Zhishan Zhang1Fang Zhou2Hongquan Ji3Yun Tian4Yan Guo5Yang Lv6Zhongwei Yang7Guojin Hou8Department of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalAbstract Background The incidence of intertrochanteric hip fracture is expected to increase as the global population ages. It is one of the most important causes of mortality and morbidities in the geriatric population. The incidence of reverse oblique and transverse intertrochanteric (AO/OTA 31-A3) fractures is relatively low; however, the incidence of implant failure in AO/OTA 31-A3 fractures is relatively high compared with that in AO/OTA 31-A1 and A2 fractures. To date, the risk factors for implant failure in AO/OTA 31-A3 fractures treated with proximal femoral nail antirotation (PFNA) have remained ambiguous. The purpose of this study was to identify the predictive factors of implant failure in AO/OTA 31-A3 fractures treated with PFNA. Methods The data of all patients who underwent surgery for trochanteric fractures at our institution between January 2006 and February 2018 were retrospectively reviewed. All AO/OTA 31-A3 fractures treated with PFNA were included. Logistic regression analysis of potential predictors of implant failure was performed. Potential predictors included age, sex, body mass index, fracture type, reduction method, status of posteromedial support and lateral femoral wall, reduction quality, tip-apex distance and position of the helical blade in the femoral head. Results One hundred four (9.3%) patients with AO/OTA 31-A3 fractures were identified. Forty-five patients with AO/OTA 31-A3 fractures treated with PFNA were suitable for our study. Overall, implant failure occurred in six (13.3%) of forty-five patients. Multivariate analysis identified poor reduction quality (OR, 28.70; 95% CI, 1.91–431.88; p = 0.015) and loss of posteromedial support (OR, 18.98; 95% CI, 1.40–257.08; p = 0.027) as factors associated with implant failure. Conclusions Poor reduction quality and loss of posteromedial support are predictors of implant failure in reverse oblique and transverse intertrochanteric fractures treated with PFNA.http://link.springer.com/article/10.1186/s13018-019-1414-4Risk factorsImplant failureReverse oblique intertrochanteric fracturesAO/OTA 31-A3 fracturesPFNA |
| spellingShingle | Youliang Hao Zhishan Zhang Fang Zhou Hongquan Ji Yun Tian Yan Guo Yang Lv Zhongwei Yang Guojin Hou Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) Journal of Orthopaedic Surgery and Research Risk factors Implant failure Reverse oblique intertrochanteric fractures AO/OTA 31-A3 fractures PFNA |
| title | Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) |
| title_full | Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) |
| title_fullStr | Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) |
| title_full_unstemmed | Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) |
| title_short | Risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) |
| title_sort | risk factors for implant failure in reverse oblique and transverse intertrochanteric fractures treated with proximal femoral nail antirotation pfna |
| topic | Risk factors Implant failure Reverse oblique intertrochanteric fractures AO/OTA 31-A3 fractures PFNA |
| url | http://link.springer.com/article/10.1186/s13018-019-1414-4 |
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