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Presence of a Nail in the Medullary Canal; Is It Enough to Prevent Femoral Neck Shortening in Trochanteric Fracture?

Authors
 Hyung Keun Song  ;  Han Kuk Yoon  ;  Kyu Hyun Yang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1400-1405, 2014 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2014
MeSH
Aged ; Bone Nails* ; Female ; Femur Neck/diagnostic imaging* ; Hip Fractures/diagnostic imaging ; Hip Fractures/surgery* ; Humans ; Male ; Orthopedic Procedures/methods* ; Radiography ; Regression Analysis
Keywords
Intertrochanteric fracture ; femoral neck shortening ; lag screw sliding
Abstract
PURPOSE:
Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking.
MATERIALS AND METHODS:
We observed 95 patients (mean age, 75±2.8 years) with trochanteric fractures who were treated with a CMN, and evaluated the relationship between FNS and patient factors including age, gender, fracture type (AO/OTA), bone mineral density, medullary canal diameter, canal occupancy ratio (COR=nail size/canal diameter), and tip-apex distance using initial, immediate postoperative, and follow-up radiography.
RESULTS:
Univariate regression analyses revealed that the degree of FNS was significantly correlated with fracture type (A1 versus A3, p<0.001), medullary canal diameter (p<0.001), and COR (p<0.001). Multiple regression analyses revealed that FNS was strongly correlated with fracture type (p<0.001) and COR (p<0.001).
CONCLUSION:
Presence of a CMN in the medullary canal could not effectively prevent FNS in patients with low COR and in A3 type fracture.
Files in This Item:
T201402837.pdf Download
DOI
10.3349/ymj.2014.55.5.1400
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99613
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