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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research Article

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

Authors: Rocco Aicale, Nicola Maffulli

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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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.
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Metadata
Title
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
Authors
Rocco Aicale
Nicola Maffulli
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0814-1

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