Migration of the Lag Screw after Intramedullary Treatment of AO/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and without U-Blade (RC) Lag Screw and Proximal Femur Nail Antirotation (PFNA)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Diagnosis, Surgical Technique and Aftercare
2.2. Outcome Parameters
2.3. Complications
2.4. Statistical Analysis
3. Results
3.1. Time to Cut Out/Treatment
3.2. Migration of the Lag Screw/Blade
3.3. Functional Outcome
4. Discussion
Limitations
5. Conclusions
Author Contributions
Conflicts of Interest
References
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PFNA | Gamma | U-Blade | Total | |
---|---|---|---|---|
(n = 86) | (n = 82) | (n = 69) | (n = 237) | |
Male/Female | 15/71 | 19/63 | 11/58 | 45/192 |
Age (years) | 80.7±11.7 | 82.0 ± 10.0 | 83.2 ± 9.6 | 81.9 ± 10.5 |
BMI (kg/m2) | 23.4 ± 3.8 | 23.9 ± 4.6 | 24.6 ± 4.0 | 24.0 ± 4.1 |
Operation (min) | 56.5 ± 22.4 | 57.1 ± 25.3 | 67.8 ± 23.8 * | 60.5 ± 23.8 |
Lateralization | 3 | 5 | 10 | 22 |
Cut-out | 1 | 3 | 2 | 6 |
Infection (superficial) | 2 | 2 | 0 | 4 |
Complications requiring surgery | 4 (4.7%) | 12 (14.6%) | 4 (5.7%) | 8.4% |
PFNA | Gamma | U-Blade | Total | |
---|---|---|---|---|
Parker’s ratio AP | 45.1 ± 8.0 | 43.2 ± 8.1 | 47.8 ± 6.6 | 45.3 ± 7.8 |
Parker’s ratio AP f/u | 54.6 ± 8.7 * | 45.1 ± 8.3 | 49.2 ± 7.7 | 49.8 ± 8.9 |
Parker’s ratio LAT | 54.3 ± 7.7 | 55.2 ± 8.0 | 50.8 ± 7.2 | 53.6 ± 7.8 |
Parker’s ratio LAT f/u | 53.7 ± 8.4 | 55.9 ± 7.1 | 49.3 ± 6.4 | 53.0 ± 7.9 |
CalTAD | 12.6 ± 2.9 | 12.5 ± 2.9 | 14.2 ± 3.6 | 13.3 ± 3.3 |
TAD | 20.4 ± 5.0 | 18.2 ± 4.8 | 16.5 ± 3.9 | 18.5 ± 4.8 |
Lateral overhang | 14% | 8% | 8% | 10% |
PFNA | Gamma | U-Blade | Total | |
---|---|---|---|---|
Number | 1 | 3 | 2 | 6 |
Parker’s ratio AP | 39 | 48.7 ± 5.6 | 50.5 ± 3.5 | 47.9 ± 5.8 |
Parker’s ratio LAT | 67 | 58.3 ± 7.6 | 60.5 ± 4.9 | 56.6 ± 11.6 |
CalTAD | 18.7 | 14.6 ± 1.4 | 15.0 ± 1.4 | 15.3 ± 1.9 |
TAD | 32.8 * | 18.3 ± 5.9 | 17.1 ± 4.3 | 20.0 ± 7.3 |
Lateral overhang | 6% | 11% | 7% | 9% |
PFNA | Gamma | U-Blade | Total | |
---|---|---|---|---|
Implant breakage | 3 | 3 | ||
lateralization | 1 | 2 | 3 | |
Wound infection | 1 * | 1 * | 2 | |
Secondary femur fracture | 1 | 1 | 2 | |
Non-union | 1 | 1 | ||
Overall % | 2.3% | 8.5% | 2.9% | 4.6% |
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Lang, N.W.; Breuer, R.; Beiglboeck, H.; Munteanu, A.; Hajdu, S.; Windhager, R.; Widhalm, H.K. Migration of the Lag Screw after Intramedullary Treatment of AO/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and without U-Blade (RC) Lag Screw and Proximal Femur Nail Antirotation (PFNA). J. Clin. Med. 2019, 8, 615. https://doi.org/10.3390/jcm8050615
Lang NW, Breuer R, Beiglboeck H, Munteanu A, Hajdu S, Windhager R, Widhalm HK. Migration of the Lag Screw after Intramedullary Treatment of AO/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and without U-Blade (RC) Lag Screw and Proximal Femur Nail Antirotation (PFNA). Journal of Clinical Medicine. 2019; 8(5):615. https://doi.org/10.3390/jcm8050615
Chicago/Turabian StyleLang, Nikolaus Wilhelm, Robert Breuer, Hannes Beiglboeck, Alexandru Munteanu, Stefan Hajdu, Reinhard Windhager, and Harald Kurt Widhalm. 2019. "Migration of the Lag Screw after Intramedullary Treatment of AO/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and without U-Blade (RC) Lag Screw and Proximal Femur Nail Antirotation (PFNA)" Journal of Clinical Medicine 8, no. 5: 615. https://doi.org/10.3390/jcm8050615