Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Faculty of Medicine, International Islamic University Malaysia
2016
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| Online Access: | http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf |
| _version_ | 1825649718100754432 |
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| author | Goh, Kian Liang Zakaria@Mohamad, Zamzuri Sharifudin, Mohd Ariff Mohamed Amin, Mohamed Azril |
| author_facet | Goh, Kian Liang Zakaria@Mohamad, Zamzuri Sharifudin, Mohd Ariff Mohamed Amin, Mohamed Azril |
| author_sort | Goh, Kian Liang |
| collection | IIUM |
| description | Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuab |
| first_indexed | 2024-03-05T23:51:40Z |
| format | Article |
| id | oai:generic.eprints.org:50898 |
| institution | International Islamic University Malaysia |
| language | English |
| last_indexed | 2024-03-05T23:51:40Z |
| publishDate | 2016 |
| publisher | Faculty of Medicine, International Islamic University Malaysia |
| record_format | dspace |
| spelling | oai:generic.eprints.org:508982016-07-28T01:52:29Z http://irep.iium.edu.my/50898/ Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? Goh, Kian Liang Zakaria@Mohamad, Zamzuri Sharifudin, Mohd Ariff Mohamed Amin, Mohamed Azril RD701 Orthopedics Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuab Faculty of Medicine, International Islamic University Malaysia 2016-06 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf Goh, Kian Liang and Zakaria@Mohamad, Zamzuri and Sharifudin, Mohd Ariff and Mohamed Amin, Mohamed Azril (2016) Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? International Medical Journal Malaysia, 15 (1). pp. 31-34. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/Volume%2015%20No%201/original_article/Vol15No1JUNE-2016-031-034.pdf |
| spellingShingle | RD701 Orthopedics Goh, Kian Liang Zakaria@Mohamad, Zamzuri Sharifudin, Mohd Ariff Mohamed Amin, Mohamed Azril Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title | Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title_full | Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title_fullStr | Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title_full_unstemmed | Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title_short | Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? |
| title_sort | intertrochanteric fracture fixation with dynamic hip screw is tip apex distance measurement useful for predicting fixation failure |
| topic | RD701 Orthopedics |
| url | http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf |
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