Greater rate of cephalic screw mobilisation following proximal femoral nailing in hip fractures with a tip–apex distance (TAD) and a calcar referenced TAD greater than 25 mm

Abstract Background To ascertain whether the tip–apex distance (TAD), calcar referenced TAD (CalTAD), and the sum of both (TADcalTAD) are predictive measurements of mobilisation of the cephalic screw in patients with trochanteric hip fractures. Methods Between 2014 and 2015, 68 patients (mean age 86...

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Bibliographic Details
Main Authors: Rocco Aicale, Nicola Maffulli
Format: Article
Language:English
Published: BMC 2018-05-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Hip
TAD
Online Access:http://link.springer.com/article/10.1186/s13018-018-0814-1
Description
Summary:Abstract Background To ascertain whether the tip–apex distance (TAD), calcar referenced TAD (CalTAD), and the sum of both (TADcalTAD) are predictive measurements of mobilisation of the cephalic screw in patients with trochanteric hip fractures. Methods Between 2014 and 2015, 68 patients (mean age 86 years, 45 females, 23 males) with a trochanteric hip fracture underwent intramedullary nailing. The TAD and CalTAD were measured, and for each parameter, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results There is evidence of a statistically significant association between a TAD and CalTAD greater than 25 mm and a TADcalTAD greater than 50 mm and mobilisation of the cephalic screw. All measurements have similar sensitivity, but the TAD presents the highest specificity (p < 0.01). Conclusion To avoid the risk of mobilisation of the cephalic screw and possible subsequent failure of the construct, surgeons should strive for a TAD and CalTAD less than 25 mm and a TADcalTAD less than 50 mm when using intramedullary fixation.
ISSN:1749-799X