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Correction of lag screw guide pins inappropriately placed during intramedullary hip nailing

Authors
 Jin Park  ;  Si Young Park  ;  Han Kook Yoon  ;  Dae Ya Kim  ;  Hye Yeon Lee  ;  Kyu Hyun Yang 
Citation
 INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, Vol.39(10) : 1134-1140, 2008 
Journal Title
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
ISSN
 0020-1383 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Bone Nails* ; Female ; Fluoroscopy ; Fracture Fixation, Intramedullary/instrumentation ; Fracture Fixation, Intramedullary/methods* ; Hip Fractures/diagnostic imaging ; Hip Fractures/surgery* ; Humans ; Male ; Middle Aged ; Observer Variation ; X-Ray Intensifying Screens
Keywords
Hip fractures ; Intramedullary hip nailing ; Guide pin ; Anteversion
Abstract
INTRODUCTION: Lag screw position is one of the most important controllable factors in trochanteric fracture fixation. However, it is sometimes difficult to handle the lag screw guide pin during intramedullary hip nailing. In this study, causes of guide pin shift and correction of malposition were investigated.

METHODS: The movements of guide pins during fracture fixation were traced fluoroscopically using 35 embalmed, mainly anteverted femora, angles were measured in the anteroposterior and lateral planes and necessary corrections calculated.

RESULTS: In the proximal anteverted femur, posterior correction of an inappropriately placed guide pin in the lateral plane led to an inferior shift in the anteroposterior fluoroscopic view, and vice versa. Mean anteversion, alpha, beta, and beta' angles were 13.1 degrees (5-29 degrees ), 10.9 degrees (4-18 degrees ), 4.6 degrees (0-10 degrees ) and 4.4 degrees (0-9 degrees ), respectively. The beta' angle was directly proportional to the anteversion angle only, i.e. Y=0.27X+0.65 (R(2)=0.79), p<0.001.

CONCLUSIONS: In the proximal anteverted femur, guide pin shift in the anteroposterior fluoroscopic view occurred during correction of pin position in the lateral plane. The amount of shift was directly related to the amount of anteversion.
Full Text
http://www.sciencedirect.com/science/article/pii/S0020138308001915
DOI
10.1016/j.injury.2008.04.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Si Young(박시영)
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Yoon, Han Kook(윤한국)
Lee, Hye Yeon(이혜연) ORCID logo https://orcid.org/0000-0001-6945-1967
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106376
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