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The Utility of the Tip-Apex Distance in Predicting Axial Migration and Cutout With the Trochanteric Fixation Nail System Helical Blade. J Orthop Trauma 2016 06;30(6):e207-11 PMID: 26655519

Pubmed ID

26655519

DOI

10.1097/BOT.0000000000000505

Abstract

OBJECTIVES: To determine whether a tip-apex distance (TAD) <20 mm is associated with a higher rate of axial migration and perforation with the Trochanteric Fixation Nail (TFN) System helical blade implant.

DESIGN: Retrospective.

SETTING: Level I Trauma Center.

PARTICIPANTS: Four hundred forty-three patients surgically treated for proximal femur fractures were identified through a query of Current Procedural Terminology code 27245 from January 2009 to February 2013. A total of 258 patients treated with the TFN helical blade system were included in the study.

MAIN OUTCOME MEASURED: The association of axial migration and perforation with the measured TAD.

RESULTS: The overall rate of mechanical complications was 10.1%. The average TAD was 20.4 mm. Axial perforation occurred in 8 patients (3.4%). Axial migration up to subchondral bone without perforation occurred in 3 patients (1.1%). Only 1 fracture failed in varus (0.38%). There was a significant difference in the rates of combined axial migration and perforation with a TAD <20 mm (P = 0.03). Logistic regression model demonstrated increased odds for combined axial cutout and migration with TAD less than 20 (odds ratio = 1.15, P = 0.01).

CONCLUSIONS: A TAD <20 mm was associated with an increased frequency of axial migration and cutout with the TFN helical blade.

LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Author List

Flores SA, Woolridge A, Caroom C, Jenkins M

Author

Adam Neal Wooldridge MD, MPH Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




Scopus

2-s2.0-84949604308   6 Citations

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Aged, 80 and over
Bone Nails
Equipment Design
Equipment Failure
Female
Follow-Up Studies
Foreign-Body Migration
Fracture Fixation, Intramedullary
Fracture Healing
Hip Fractures
Humans
Incidence
Injury Severity Score
Logistic Models
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Sex Factors
Tomography, X-Ray Computed
Trauma Centers
jenkins-FCD Prod-336 69ef4a6b262d135130251597d5d39873903802b5