Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery?
<i>Background and Objectives:</i>: There were limited studies which investigated nail diameter as a predictor for cephalomedullary nail (CMN) failure in intertrochanteric fracture (ITF). We aimed to evaluate the surgical outcomes of CMN in fragility ITF following nail–canal (N–C) diamete...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/59/6/1035 |
| Summary: | <i>Background and Objectives:</i>: There were limited studies which investigated nail diameter as a predictor for cephalomedullary nail (CMN) failure in intertrochanteric fracture (ITF). We aimed to evaluate the surgical outcomes of CMN in fragility ITF following nail–canal (N–C) diameter discordance. <i>Materials and Methods</i>: From November 2010 to March 2022, we retrospectively reviewed 120 consecutive patients who underwent CMN surgeries due to fragility ITF. We included patients with acceptable reduction and a tip–apex distance ≤ 25 mm. The N–C diameter differences both in anterior–posterior (AP) and lateral-view X-rays were measured, and we compared the number of excessive sliding instances and the rate of implant failure between the N–C concordance (≤3 mm) and discordance (>3 mm) group. Simple linear regression was used to determine the strength of the relationship between the N–C difference and sliding distance. <i>Results</i>: The sliding distance showed no differences between the groups in the AP (3.6 vs. 3.3 mm, <i>p</i> = 0.75) and lateral view (3.5 vs. 3.4 mm, <i>p</i> = 0.91). For analyses in the AP view, the AP-concordance and AP-discordance groups had 14 (25%) and 14 patients (22%) with a sliding distance of >5 mm (<i>p</i> = 0.69), while treatment failure occurred in 3 (5%) and 3 (3%) patients, respectively (<i>p</i> = 0.66). For analyses in the lateral view, the lat-concordance and lat-discordance groups had 8 (27%) and 20 patients (22%) with a sliding distance of >5 mm (<i>p</i> = 0.62), while treatment failure occurred in 1 (3%) and 4 (4%) patients, respectively (<i>p</i> = 1.00). Linear regression analyses showed that the N–C difference in either views was not a significant predictor of sliding distance in both the AP (R<sup>2</sup> = 0.002, <i>p</i> = 0.60) and lateral views (R<sup>2</sup> = 0.007, <i>p</i> = 0.35). <i>Conclusions</i>: If appropriate fracture reduction and fixation are achieved, the N–C discordance of short CMN does not affect treatment outcomes in ITF. |
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| ISSN: | 1010-660X 1648-9144 |