Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report
Summary: Trochanteric femur fractures have traditionally been treated surgically with compression hip screws or cephalomedullary nails. With the increasing use of cephalomedullary nails, potential complications from this technique have surfaced. One of them is the potential for varus malreduction of...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Trauma Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S235264402300033X |
| _version_ | 1797869781058060288 |
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| author | Takahiro Waki Tomohiro Matsumura Genta Fukumoto Toshiharu Takami Tomonori Yano Kenjiro Ito Shinji Matsushima Tomoyuki Matsumoto Ryosuke Kuroda |
| author_facet | Takahiro Waki Tomohiro Matsumura Genta Fukumoto Toshiharu Takami Tomonori Yano Kenjiro Ito Shinji Matsushima Tomoyuki Matsumoto Ryosuke Kuroda |
| author_sort | Takahiro Waki |
| collection | DOAJ |
| description | Summary: Trochanteric femur fractures have traditionally been treated surgically with compression hip screws or cephalomedullary nails. With the increasing use of cephalomedullary nails, potential complications from this technique have surfaced. One of them is the potential for varus malreduction of trochanteric femur fractures, known as the “wedge effect”, which is the distraction of fracture fragments generated during reamer and nail passage resulting in varus malalignment at the neck-shaft angle. Although trochanteric nonunion in the non-elderly is exceedingly rare, we experienced one such case after nailing due to the wedge effect that was subsequently successfully treated with a compression hip screw without bone grafting. Therefore, in the case of stable pertrochanteric fractures (AO/OTA 31A1) in younger patients, compression hip screw surgery may be the better choice of initial surgery to avoid later nonunion. |
| first_indexed | 2024-04-10T00:17:00Z |
| format | Article |
| id | doaj.art-bc6325d865d34629a14239cd6e88da20 |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-04-10T00:17:00Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-bc6325d865d34629a14239cd6e88da202023-03-16T05:04:52ZengElsevierTrauma Case Reports2352-64402023-04-0144100785Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case reportTakahiro Waki0Tomohiro Matsumura1Genta Fukumoto2Toshiharu Takami3Tomonori Yano4Kenjiro Ito5Shinji Matsushima6Tomoyuki Matsumoto7Ryosuke Kuroda8Department of Orthopedic Surgery, Akashi Medical Center, Akashi, Japan; Corresponding author at: Department of Orthopedic Surgery, Akashi Medical Center, 743-33 Yagi, Okubo-cho, Akashi 674-0063, Japan.Department of Emergency and Critical Care Medicine, School of Medicine, Jichi Medical University, Tochigi, JapanDepartment of Orthopedic Surgery, Akashi Medical Center, Akashi, JapanDepartment of Orthopedic Surgery, Akashi Medical Center, Akashi, JapanDepartment of Orthopedic Surgery, Akashi Medical Center, Akashi, JapanDepartment of Orthopedic Surgery, Akashi Medical Center, Akashi, JapanDepartment of Orthopedic Surgery, Akashi Medical Center, Akashi, JapanDepartment of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDepartment of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanSummary: Trochanteric femur fractures have traditionally been treated surgically with compression hip screws or cephalomedullary nails. With the increasing use of cephalomedullary nails, potential complications from this technique have surfaced. One of them is the potential for varus malreduction of trochanteric femur fractures, known as the “wedge effect”, which is the distraction of fracture fragments generated during reamer and nail passage resulting in varus malalignment at the neck-shaft angle. Although trochanteric nonunion in the non-elderly is exceedingly rare, we experienced one such case after nailing due to the wedge effect that was subsequently successfully treated with a compression hip screw without bone grafting. Therefore, in the case of stable pertrochanteric fractures (AO/OTA 31A1) in younger patients, compression hip screw surgery may be the better choice of initial surgery to avoid later nonunion.http://www.sciencedirect.com/science/article/pii/S235264402300033XPertrochanteric fractureNonunionYoungRevision surgeryWedge effectNail |
| spellingShingle | Takahiro Waki Tomohiro Matsumura Genta Fukumoto Toshiharu Takami Tomonori Yano Kenjiro Ito Shinji Matsushima Tomoyuki Matsumoto Ryosuke Kuroda Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report Trauma Case Reports Pertrochanteric fracture Nonunion Young Revision surgery Wedge effect Nail |
| title | Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report |
| title_full | Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report |
| title_fullStr | Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report |
| title_full_unstemmed | Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report |
| title_short | Revision surgery in a middle-aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail: A case report |
| title_sort | revision surgery in a middle aged patient with pertrochanteric fracture nonunion due to wedge effect caused by cephalomedullary nail a case report |
| topic | Pertrochanteric fracture Nonunion Young Revision surgery Wedge effect Nail |
| url | http://www.sciencedirect.com/science/article/pii/S235264402300033X |
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