CT scans better assess lateral wall morphology of "stable appearing" intertrochanteric (IT) femur fractures and predict early failure of sliding hip screw (SHS) fixation.
LATERAL wall
cephalomedullary nail
geriatric hip fracture
intertrochanteric hip fracture
sliding hip screw
stable
unstable
Journal
OTA international : the open access journal of orthopaedic trauma
ISSN: 2574-2167
Titre abrégé: OTA Int
Pays: United States
ID NLM: 101770383
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
19
09
2020
accepted:
12
06
2021
entrez:
8
11
2021
pubmed:
9
11
2021
medline:
9
11
2021
Statut:
epublish
Résumé
To compare the efficacy of plain x-ray images and computed tomography (CT) to assess the morphology of the lateral wall (LW) component of intertrochanteric (IT) femur fractures and determine predictors of early fixation failure. Retrospective cohort study. Level-one trauma center. One hundred forty-two adult patients with IT fractures treated with either a sliding hip screw (SHS) or a cephalomedullary nail (CMN) who had both pre-op plain x-ray images and CT scans with at least 6 weeks of follow-up were reviewed. Preoperative CT scan and plain radiographs of the affected hip. Lateral wall assessment based on plain x-rays versus CT imaging in relation to implant failure. One hundred forty-two patients met inclusion criteria, 105 patients treated with a CMN, and 37 with a SHS. There was a poor correlation between the assessment of the LW on plain x-ray images and CT scans. Failures in the SHS group were significantly associated with all CT measurements ( Plain film images are not accurate for assessing lateral wall morphology/integrity and are not predictive of SHS implant failures. Our novel CT measurements were effective at detecting lateral wall patterns at risk for treatment failure with SHS implants.Level of Evidence: Level III.
Identifiants
pubmed: 34746672
doi: 10.1097/OI9.0000000000000140
pii: OTAI-D-20-00048
pmc: PMC8568429
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e140Informations de copyright
Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
J Bone Joint Surg Am. 2007 Mar;89(3):470-5
pubmed: 17332094
J Arthroplasty. 2013 Sep;28(8 Suppl):45-7
pubmed: 23891060
J Bone Joint Surg Am. 2015 Dec 2;97(23):1905-12
pubmed: 26631990
JAMA. 2009 Oct 14;302(14):1573-9
pubmed: 19826027
J Orthop Trauma. 2015 Apr;29 Suppl 4:S4-9
pubmed: 25756825
Skeletal Radiol. 2010 Jun;39(6):543-9
pubmed: 20405284
Injury. 2017 Feb;48(2):277-284
pubmed: 28040260
J Bone Joint Surg Am. 2010 May;92(5):1105-14
pubmed: 20439655
J Arthroplasty. 2013 May;28(5):855-9
pubmed: 23489728
Injury. 2015;46(6):1047-53
pubmed: 25890863
Injury. 2017 Feb;48(2):419-431
pubmed: 27903406
Cochrane Database Syst Rev. 2010 Sep 08;(9):CD000093
pubmed: 20824825
J Am Acad Orthop Surg. 2008 Nov;16(11):665-73
pubmed: 18978289
J Orthop Trauma. 2017 Jan;31(1):1-8
pubmed: 27763958
Int Orthop. 2016 May;40(5):1009-17
pubmed: 26141048
J Orthop Trauma. 2018 Jan;32 Suppl 1:S1-S170
pubmed: 29256945
J Orthop Trauma. 2009 Jul;23(6):403-7
pubmed: 19550225
J Bone Joint Surg Am. 2010 Apr;92(4):792-8
pubmed: 20360500
Injury. 2017 Dec;48(12):2762-2767
pubmed: 29102044
Bone Joint J. 2013 Aug;95-B(8):1134-8
pubmed: 23908432
Clin Orthop Relat Res. 2015 Nov;473(11):3647-55
pubmed: 26208608
J Bone Joint Surg Am. 1995 Jul;77(7):1058-64
pubmed: 7608228
J Bone Joint Surg Am. 2009 Mar 1;91(3):712-9
pubmed: 19255235
Injury. 2012 Jun;43(6):686-93
pubmed: 21752370
J Orthop Trauma. 2009 Jul;23(6):471-8
pubmed: 19550237
J Arthroplasty. 2004 Apr;19(3):329-33
pubmed: 15067646