Central head perforation, or "cut through," caused by the helical blade of the proximal femoral nail antirotation.

Abstract:

OBJECTIVE:This study was designed to investigate the specific type and incidence of implant failure in patients with a proximal femur fracture treated with a proximal femoral nail antirotation. This device has a helical-shaped blade as a neck-head holding device, instead of the lag screw used in other intramedullary nails. The advantage of the blade is believed to originate from bone impaction and a larger bone-implant interface in comparison with the lag screw design, with consequential greater mechanical resistance to torsion in the cancellous bone. PATIENTS AND METHODS:This is a retrospective cohort study conducted at the state hospital of Winterthur, Switzerland. From December 2006 until November 2008, 210 consecutive patients were treated with a pertrochanteric femur fracture (OTA type 31-A1, 31-A2, and 31-A3) using a proximal femoral nail antirotation. One hundred and twelve patients were followed up clinically for a minimum of 12 months after discharge. Clinical and radiologic assessment of fracture healing and/or implant failure was investigated. RESULTS:We report 7 cases of implant failure with a "Cut Through," defined as a postoperative central perforation of the spiral blade into the hip joint, without any displacement of the neck-head fragment. CONCLUSIONS:Cut through needs to be distinguished from the well-known anterocranial perforation combined with a varus displacement of the neck-head fragment, known as "Cut Out," seen with intramedullary nails utilizing lag screws. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

authors

Frei HC,Hotz T,Cadosch D,Rudin M,Käch K

doi

10.1097/BOT.0b013e31822c53c1

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

e102-7

issue

8

eissn

0890-5339

issn

1531-2291

journal_volume

26

pub_type

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