Abstract:
OBJECTIVE:At present, cephalomedullary nail is the most frequently used implant in the management of intertrochanteric fractures around the world. The implant design and fixation techniques of the cephalomedullary nail have been continuously improved to ensure uncomplicated bone union during the past decade. However, a degree of reduction loss during bone healing is still not rare in clinical work. Many attributed this complication to misoperation during the surgery and hold that a series of techniques and tips could help to avoid the loss of reduction. However, until now there has been no research to explore whether the reduction loss after the operation can be fully prevented in the best cases. The purposes of the study are as follows: (i) to evaluate the efficiency of the current established CMN techniques; (ii) to quantify the loss of reduction under an appropriately implanted CMN to anatomically realigned intertrochanteric fractures; and (iii) to explore the possible underlying causes for the inevitable loss of reduction. METHODS:In the retrospective study, 163 consecutive cases with the intertrochanteric fractures fixed with standard cephalomedullary nail technique were reviewed. The anatomical reduction and optimal positioning of the nail were confirmed by postoperative imaging. The fracture types ranged from 31-A1.1-2.3 according to the OTA/AO fracture classification. One hundred and fifteen cases with stable fracture types (31A1.1-2.1) were allocated to Group A, and 48 cases with unstable 31A2.2-2.3 fracture types were allocated to Group B. The radiological measurements included femoral neck shortening, loss of the neck-shaft angle, cutout, and cut-through of the blade. The outcomes between postoperative and 1 year after the operation were evaluated and compared. RESULTS:The patients consisted of 66 males and 97 females with an average age of 69.4 (range: 46-78, SD: 14.6) years. At the 1-year follow-up, no fixation failure or nonunion was observed in each group. The mean femoral neck shortening and loss of the neck-shaft angle were 4.47 mm (range: 0.43-17.68, SD: 3.71) and 5.4° (range: 0.51-19.10, SD: 3.58) separately. The mean cutout and cut-through were 1.84 mm (range: 0.24-11.30, SD: 2.33) and 1.25 mm (range: 0.51-10.29, SD: 1.74). The average femoral neck shortening and loss of the neck-shaft angle were higher in Group B than Group A. Among the 23 cases with the femoral neck shortening more than 10 mm, 19 cases (16.5%) were from Group A and four cases (8.3%) were from Group B. There were nine (7.8%) cases with the loss of the neck-shaft angle more than 10° in Group A and six (12.5%) cases in Group B. CONCLUSIONS:Current established CMN techniques are efficient in treating intertrochanteric femoral fracture. However, even with currently consensual techniques of cephalomedullary nail, the process of fracture healing still risks the loss of reduction, although the migration of the blade could be minimized. This situation may associate with the intrinsic design of the CMN and further improvement is still needed.
journal_name
Orthop Surgjournal_title
Orthopaedic surgeryauthors
Pang Y,He QF,Zhu LL,Bian ZY,Li MQdoi
10.1111/os.12828subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1998-2003issue
6eissn
1757-7853issn
1757-7861journal_volume
12pub_type
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12355
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To compare the superior-level facet joint violations (FJV) between robot-assisted (RA) percutaneous pedicle screw placement and conventional open fluoroscopic-guided (FG) pedicle screw placement in a prospective cohort study. METHODS:This was a prospective cohort study without randomization. One-hundred pati...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12534
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of the postoperative long-term effect of the treatment of single-level cervical spondylosis through anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR). METHODS:This is a retrospective contrastive study, which was conducted for the...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12634
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:The prevention and treatment of the common complication of cerebrospinal fluid leakage (CSFL) during anterior approach cervical spine surgery for severe ossification of the posterior longitudinal ligament (OPLL) is documented. METHOD:A retrospective analysis of 47 patients with severe cervical OPLL aged 39 t...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12007
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical outcomes of anterior and posterior instrumentation with different debridement and graft fusion methods for multi-level contiguous thoracic spinal tuberculosis. METHODS:We retrospectively evaluated 81 patients with multi-level contiguous thoracic spinal tuberculosis who underwent ante...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12288
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:To investigate the association between the number of metastases to the spine and survival in patients with metastatic spinal cord compression (MSCC), as well as the prognosis difference between patients with solitary spinal metastasis (SSM) and multiple spinal metastases (MSM). METHODS:Three institutional d...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12470
更新日期:2019-06-01 00:00:00
abstract::A 66-year-old woman had sustained crush injury 3 hours prior to her presentation to our hospital. The diagnosis was defined as lateral tibial plateau fracture of the right knee (Schatzker III). Supine position was set up and a pad was put under the affected hip. After sterilization of the surgical field the sterilized...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12205
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Total knee arthroplasty (TKA) is one of the most universal and effective means for treating terminal stage osteoarthritis (OA) of knee. Accurate intramedullary guide of femur is the basis for the distal femoral cuts. Determining the surgical transepicondylar axis (sTEA) is the key to reconstruction of the fem...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To develop a novel screw positioning method to improve the treatment of unstable thoracolumbar fractures. METHODS:A total of 72 patients with unstable thoracolumbar fractures who were treated with anterior screw-rod interfixation from January 2011 to October 2015 were included in this clinical study. Those p...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12506
更新日期:2019-08-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12099
更新日期:2014-05-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12461
更新日期:2019-06-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type:
doi:10.1111/os.12868
更新日期:2020-12-03 00:00:00
abstract::The authors describe a hybrid technique that involves a combination of open decompression and posterior lumbar interbody fusion (PLIF) and percutaneously inserted pedicle screws. This technique allows performance of PLIF and decompression via a midline incision and approach without compromising operative time and visu...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12042
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of residual varus and valgus deformity on the stress distribution of the knee joint after tibial fracture malunion. METHODS:Fourteen adult cadaver specimens were selected to establish the models of tibial fractures, which were fixed subsequently at neutral position (anatomical reduc...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12668
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of hip replacement and intramedullary nails for treating unstable intertrochanteric fractures in elderly patients. METHODS:Randomized clinical trials (RCTs) to compare hip replacement with intramedullary nail in the management of elderly patients with unstable intertrochan...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,meta分析
doi:10.1111/os.12532
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To assess the difference between drainage and non-drainage after total hip arthroplasty (THA) in Chinese subjects by evaluating post-operative complications and joint function. METHODS:One hundred and sixty-eight patients undergoing THA were randomly allocated into drainage (83 patients) and non-drainage gro...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1111/os.12092
更新日期:2014-02-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12559
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:Occipitocervical fusion (OCF) is an effective treatment for instability of occipitocervical junction (OCJ). The occipital condyle screw serves as a novel surgical technique for occipitocervical fixation. However, the intraoperative procedures for the occipital condyle screw technique have relied on surgeons'...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12700
更新日期:2020-06-01 00:00:00
abstract::Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,评审
doi:10.1111/os.12334
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the functional outcomes of arthroscopic anatomical repair of anterior talofibular ligament (ATFL) in the treatment of chronic lateral ankle instability (CLAI) during medium- and long-term follow-up. METHODS:From September 2014 to August 2017, the data of 37 patients (23 males, 14 females; 12 left...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12651
更新日期:2020-04-01 00:00:00
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journal_title:Orthopaedic surgery
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更新日期:2018-08-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12815
更新日期:2020-12-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1111/os.12256
更新日期:2016-08-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12297
更新日期:2016-11-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1111/os.12329
更新日期:2017-05-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12391
更新日期:2018-08-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2009.00020.x
更新日期:2009-05-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12593
更新日期:2020-02-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2011.00135.x
更新日期:2011-08-01 00:00:00
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journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12775
更新日期:2020-12-01 00:00:00