Migration of the Lag Screw After Intramedullary Treatment of AO/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and Without U-Blade (RC)...

Overview

Journal J Clin Med

Specialty General Medicine

Date 2019 May 10

PMID 31067639

Citations 9

Authors

Nikolaus Wilhelm Lang

Robert Breuer

Hannes Beiglboeck

Alexandru Munteanu

Stefan Hajdu

Reinhard Windhager

Harald Kurt Widhalm

Affiliations

Soon will be listed here.

Abstract

The best intramedullary nail for the treatment of unstable AO/OTA 31.A2.1-3 fractures remains uncertain. A total of 237 patients (45 male, 192 female) were eligible for the assessment with an average age of 81.9 ± 10.5 years and a minimum follow-up of six months. We assessed the cut-out rate, the TAD and calTAD (Tip Apex distance) of three different implants. An overall cut-out rate of 2.5% ( = 6) was observed. The cut-out rate was 1.2% ( = 1) in the Proximal Femur Nail Antirotation (PFNA) group, 3.7% ( = 3) in the Gamma Nail group and 2.9% ( = 2) in the Gamma3 with a U-Blade (RC) lag-screw group. The TAD and calTAD differed between the cut-out and non-cut group-20.0 mm vs. 18.5 mm and 13.1 mm vs. 15.3 mm, respectively. A significantly higher TAD of 32.5 mm could be seen in the cut-out after PFNA ( < 0.0001). The only significant change in follow-up using Parker's ratio was observed in the PFNA group ( < 0.0001). The rate of patients requiring surgery after complications was 8.4% ( = 20) without any significant difference between the three groups. The PFNA blade showed significant migration within the femoral head, however the cut-out rate remained the smallest compared to Gamma3 with or without additional U-Blade (RC) lag screw.

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