What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?
1Department of Orthopedics and Traumatology, Karabük University Faculty of Medicine, Karabük, Türkiye
2Department of Orthopaedics and Rehabilitation, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
Keywords: Cephalomedullary nail, femur, hip fracture, implant failure, nail size.
Objectives: The aim of this study was to investigate the effect of distal nail diameter in the treatment of geriatric intertrochanteric femur fractures (ITFFs).
Patients and methods: Between January 2017 and January 2021, a total of 91 patients (34 males, 57 females; mean age: 80.6±7.8 years; range, 65 to 96 years) who had osteosynthesis due to an ITFF with a short cephalomedullary nail (CMN) were retrospectively analyzed. The patients were divided into two groups: Group 1 (n=18) included patients with a distal nail diameter of ≤10 mm and Group 2 (n=73) included patients with a distal nail diameter of >10 mm. Patients’ age, sex, fracture type according to AO classification, intramedullary femoral canal diameter, canal fit ratio, operation duration, reduction quality, the distal diameter of the CMN, and complications were evaluated.
Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the mean age, sex, fracture type, mean intramedullary canal diameter, reduction quality, and implant failure (p>0.05). The mean operation duration was significantly shorter in Group 2 (112.9±39.9 min) compared to Group 1 (128.8±36.4 min) (p=0.048). A total of three intraoperative peri-implant fractures occurred which included one 9 mm nail, one 12 mm nail, and one 14 mm nail.
Conclusion: Our study results suggest that there is no advantage of using a >10-mm CMN in the treatment of geriatric ITFFs in terms of reducing the implant failure rate. However, the utility of a >10-mm CMN can reduce the operation duration.
Citation: Ergişi Y, Özdemir E, Korkmazer S, Kekeç H, Altun O, Yalçın N. What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?. Jt Dis Relat Surg 2022;33(3):639-644.
The study protocol was approved by the Karabuk University Non-Invasive Clinical Research Ethics Committee (date: 15.12.2021, no: 2021/759). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Idea/concept, design, control/ supervision, data processing, literature review, writing of the article, critical review: Y.E.; Idea/concept, design, control/ supervision, data processing and analysis, literature review, writing of the article, critical review: E.Ö.; Idea/concept, design, literature review, writing of the article, critical review: S.K.; Idea/concept, data collection, literature review, writing of the article: H.K., O.A.; Idea/concept, design, control/supervision, writing of the article, critical review: N.Y.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.