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...
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MDPI AG
2023-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/6/1035 |
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| author | Eic Ju Lim Ji Wan Kim Jeuk Lee Chul-Ho Kim |
| author_facet | Eic Ju Lim Ji Wan Kim Jeuk Lee Chul-Ho Kim |
| author_sort | Eic Ju Lim |
| collection | DOAJ |
| description | <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. |
| first_indexed | 2024-03-11T02:11:33Z |
| format | Article |
| id | doaj.art-9efbc542d61b45bfb1439fbf8283076e |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T02:11:33Z |
| publishDate | 2023-05-01 |
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| spelling | doaj.art-9efbc542d61b45bfb1439fbf8283076e2023-11-18T11:30:32ZengMDPI AGMedicina1010-660X1648-91442023-05-01596103510.3390/medicina59061035Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery?Eic Ju Lim0Ji Wan Kim1Jeuk Lee2Chul-Ho Kim3Department of Orthopedic Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Republic of KoreaDepartment of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of KoreaDepartment of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of KoreaDepartment of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea<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.https://www.mdpi.com/1648-9144/59/6/1035intertrochanteric fracturemedullary canalimplant diameterdiscordance |
| spellingShingle | Eic Ju Lim Ji Wan Kim Jeuk Lee Chul-Ho Kim Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? Medicina intertrochanteric fracture medullary canal implant diameter discordance |
| title | Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? |
| title_full | Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? |
| title_fullStr | Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? |
| title_full_unstemmed | Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? |
| title_short | Is Nail–Canal Diameter Discordance a Risk Factor for the Excessive Sliding of Cephalomedullary Nails in Geriatric Intertrochanteric Fracture Surgery? |
| title_sort | is nail canal diameter discordance a risk factor for the excessive sliding of cephalomedullary nails in geriatric intertrochanteric fracture surgery |
| topic | intertrochanteric fracture medullary canal implant diameter discordance |
| url | https://www.mdpi.com/1648-9144/59/6/1035 |
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