the Cement Augmented Screws of TFNA Nails
Conditions
Keywords
TFNA, Hip fracture, Augmentation, Cement, Cut-out
Brief summary
Intramedullary nailing is the standard treatment of trochanteric fractures. Mechanical failure such as cut-out and cut-through are associated with high rates of revision surgery, functional impairment and mortality. Augmentation of the implant have shown encouraging results in reducing the number of mechanical failures. The aim of the study was to evaluate the rate of mechanical failure of the cement augmented screws of TFNA nails. A descriptive, retrospective, multi-operator, single-centre study was performed at our level 1 trauma centre. Patients were included if they were \> 65 years of age, presented with a trochanteric fracture treated with an augmented TFNA nail. The primary outcome was fixation failure rate (cut-out or cut-through) at 3 and 6 postoperative months. Secondary endpoints were intraoperative data, clinical scores, and radiographic analysis.
Interventions
None listed
Sponsors
University Hospital, Brest
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 65 years of age * a trochanteric fracture that occurred through a low-energy mechanism * an augmented TFNA nail
Exclusion criteria
* pathological fracture * open fracture * hips with pre-existing deformities other than osteoarthritis * a history of hip surgery * an insufficient quantity of injected cement (\< 3 mL).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fixation failure rate (cut-out or cut-through) | change at 3 and 6 postoperative months | On X rays |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parker Mobility Score | at 3 and 6 postoperative months | the minimum is 0 and maximum 9, higher scores mean a better outcome. |
| Harris Hip Score | at 3 and 6 postoperative months | the minimum is 0 and maximum 100, higher scores mean a betteroutcome. |
| the tip-apex distance | once | On X rays |
| TFNA screw position | once | On X rays |
| distribution of cement on either side of the cervicocephalic screw | once | On X rays |
| postoperative complications | at 3 and 6 postoperative months | — |
| the need for revision surgery | at 3 and 6 postoperative months | — |
| EuroQoL 5-Dimensions score | change at 3 and 6 postoperative months | the minimum is 5 and maximum 15, higher scores mean a worse outcome. |
| analysis evaluating quality of reduction | once | On X rays |
| Augmentation volume | once | — |
| length of surgery | at 3 and 6 postoperative months | — |
| radiation exposure | once | — |
| duration of hospitalisation | once | — |
| Intraoperative adverse events | once | — |
| Visual Analogue Scale score | at 3 and 6 postoperative months | the minimum is 0 and maximum 10, higher scores mean a worse outcome. |
Countries
France
Outcome results
None listed