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Study links increased rates of axial migration, cutout to tip-apex distance with helical blade implant
Results from this study demonstrated patients with proximal femur fractures treated with the trochanteric fixation nail system helical blade had increased rates of axial migration and cutout when the tip-apex distance was less than 20 mm.
Using Current Procedures Terminology codes for proximal femur fractures, researchers identified 258 patients treated with a trochanteric fixation nail helical blade system. Investigators used postoperative radiographs to assess reduction of the lesser trochanter, the tip-apex distance (TAD) and the Cleveland zone position. Interactions between independent variables and the ability of these variables to predict mechanical complications were determined with logistic regression analysis.
Results showed the overall mechanical complication rate was 10.1%. Investigators noted, on average, the TAD was 20.4 mm. There were eight patients in which axial perforation occurred, and three of these patients had axial migration up to the subchondral bone without perforation. Investigators noted one fracture failed in the varus.
According to researchers, the rates of combined axial migration and perforation with a TAD of less than 20 mm were significantly different from those with a TAD of greater than 20 mm. Results from logistic regression analysis showed there was a 1.15-times greater chance for combined axial cutout and migration when the TAD was less than 20 mm. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.