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Mechanical Complications of Proximal Femur Fractures Treated with Intramedullary Nailing: A Retrospective Study

Lopez-Hualda, Alvaro ; García-Cabrera, Esperanza Marin ; Lobato-Perez, Marina ; Martinez-Martin, Javier ; Rossettini, Giacomo ; Leigheb, Massimiliano ; Villafañe, Jorge Hugo

Medicina (Kaunas, Lithuania), 2024-05, Vol.60 (5), p.718 [Periódico revisado por pares]

Switzerland: MDPI AG

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Título:
Mechanical Complications of Proximal Femur Fractures Treated with Intramedullary Nailing: A Retrospective Study
Autor: Lopez-Hualda, Alvaro ; García-Cabrera, Esperanza Marin ; Lobato-Perez, Marina ; Martinez-Martin, Javier ; Rossettini, Giacomo ; Leigheb, Massimiliano ; Villafañe, Jorge Hugo
Assuntos: Aged ; Aged, 80 and over ; Bone Nails ; Classification ; Closed reduction ; Cohort Studies ; Complications and side effects ; Failure ; Female ; Femoral Fractures - surgery ; fracture ; Fracture Fixation, Intramedullary - adverse effects ; Fracture Fixation, Intramedullary - instrumentation ; Fracture Fixation, Intramedullary - methods ; Fractures ; hip ; Hip Fractures - surgery ; Hip joint ; Humans ; intramedullary nailing ; Male ; mechanical complications ; Medical research ; Medicine, Experimental ; Middle Aged ; Necrosis ; Older people ; Orthopedics ; Osteoporosis ; Patients ; Postoperative Complications - etiology ; Postoperative period ; Proximal Femoral Fractures ; Quality of life ; Retrospective Studies ; Risk Factors ; TFNA implant ; Transplants & implants ; Trauma
É parte de: Medicina (Kaunas, Lithuania), 2024-05, Vol.60 (5), p.718
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SourceType-Scholarly Journals-1
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Descrição: : This retrospective cohort study analyzes mechanical complications in hip fracture surgery using the Trochanteric Fixation Nail-Advanced (TFNA) implant. It investigates the correlation of these complications with demographic, intraoperative, and radiological factors, aiming to identify associated risk factors and suggest improvements in clinical surveillance and treatment strategies. : We enrolled 253 patients diagnosed with pertrochanteric hip fractures treated between 2017 and 2021, with 126 meeting the criteria for a minimum 6-month follow-up. Data on demographics, American Anesthesia Association Classification (ASA), comorbidities, AO/OTA [AO (Arbeitsgemeinschaft für Osteosynthesefragen)/OTA (Orthopedic Trauma Association)] fracture classification, procedural details, and time to failure were collected. Radiographs were evaluated for reduction quality, the tip-apex distance (TAD), progressive varus deviation, and identification of mechanical complications. Statistical analysis was performed using SPSS software. : The predominant AO/OTA fracture classification was 31A2 in 67 cases (52.7%). Reduction quality was deemed good or acceptable in 123 cases (97.6%). The mean time to failure was 4.5 months (range: 2.2-6). The average TAD was 18 mm (range: 1.2-36), with a mean progressive varus deviation of 2.44° (range: 1.30-4.14). A good or acceptable reduction quality was observed in 97.6% of cases. Mechanical complications occurred in 21.4% of patients, with significant associations found with the lateral cortex fracture, use of a TFNA implant with a 130° angle, open reduction, and absence of prior osteoporosis treatment. : The study provides insights into mechanical complications in proximal femur fractures treated with the TFNA nail, emphasizing the need for enhanced clinical and radiographic surveillance, especially in patients without osteoporosis treatment. Our findings support the necessity for further clinical studies comparing these outcomes with other implant designs and underscore the importance of personalized treatment strategies to reduce complication rates.
Editor: Switzerland: MDPI AG
Idioma: Inglês

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Mechanical Complications of Proximal Femur Fractures Treated with Intramedullary Nailing: A Retrospective Study

Lopez-Hualda, Alvaro ; García-Cabrera, Esperanza Marin ; Lobato-Perez, Marina ; Martinez-Martin, Javier ; Rossettini, Giacomo ; Leigheb, Massimiliano ; Villafañe, Jorge Hugo

Switzerland: MDPI AG

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