37-209
Importancia de la colocación del tornillo cefálico y de la distancia al apex en fracturas pertrocanté tratadas con clavo gamma
The value of crew placement and the apex distance in pertrocanteric fractures treated w i t h gamma nail
A. BARRA, J. FERNÁNDEZ-GALLART, T. JOLÍN, F. GOMAR. SERVICIO CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. HOSPITAL CLÍNICO UNIVERSITARIO DE VALENCIA. DEPARTAMENTO DE CIRUGÍA. UNIVERSIDAD DE VALENCIA.
Recepción:
16/09/2008
Aceptación:
16/09/2008
Publicación:
16/09/2008
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Resumen (ES)
Pertrochanteric fractures are the most frequent
type of proximal femur fractures. The main objectives of surgical
treatment are early mobilization and full weight bearing.
A good knowledge of the factors related to failure of the implant
is necessary to avoid them. The most important is the
cephalic screw positioning because it is most dependent on
surgical technique. We present a retrospective study about
the cephalic screws positioning in 400 pertrochanteric fractures
treated with gamma nail. We also assessed the tip-apex
distance and impaction of the fracture, looking for any relationships
between them and the failure of the implant. In our
series, 37.7% of screw failures occurs in the anterior-superior
localization, and 30.7% in posterior-inferior localization. All
cut-outs were produced in cases with a Tip Ápex distance larger
than 28 mm. The mean impaction in stable fractures was
2.27 mm and in unstable fractures was 8.26 mm.
type of proximal femur fractures. The main objectives of surgical
treatment are early mobilization and full weight bearing.
A good knowledge of the factors related to failure of the implant
is necessary to avoid them. The most important is the
cephalic screw positioning because it is most dependent on
surgical technique. We present a retrospective study about
the cephalic screws positioning in 400 pertrochanteric fractures
treated with gamma nail. We also assessed the tip-apex
distance and impaction of the fracture, looking for any relationships
between them and the failure of the implant. In our
series, 37.7% of screw failures occurs in the anterior-superior
localization, and 30.7% in posterior-inferior localization. All
cut-outs were produced in cases with a Tip Ápex distance larger
than 28 mm. The mean impaction in stable fractures was
2.27 mm and in unstable fractures was 8.26 mm.
Palabras clave (ES):
Gamma
Cadera
Fractura
Pertrocantérea
Intertrocantérea
Trocantérea
Osteosíntesis
Fijación
Tratamiento
Quirúrgico
Operatorio
Clavo
Cervicodiafisaro
Tornillo
Cefálico
Resumen (EN)
Pertrochanteric fractures are the most frequent
type of proximal femur fractures. The main objectives of surgical
treatment are early mobilization and full weight bearing.
A good knowledge of the factors related to failure of the implant
is necessary to avoid them. The most important is the
cephalic screw positioning because it is most dependent on
surgical technique. We present a retrospective study about
the cephalic screws positioning in 400 pertrochanteric fractures
treated with gamma nail. We also assessed the tip-apex
distance and impaction of the fracture, looking for any relationships
between them and the failure of the implant. In our
series, 37.7% of screw failures occurs in the anterior-superior
localization, and 30.7% in posterior-inferior localization. All
cut-outs were produced in cases with a Tip Ápex distance larger
than 28 mm. The mean impaction in stable fractures was
2.27 mm and in unstable fractures was 8.26 mm.
type of proximal femur fractures. The main objectives of surgical
treatment are early mobilization and full weight bearing.
A good knowledge of the factors related to failure of the implant
is necessary to avoid them. The most important is the
cephalic screw positioning because it is most dependent on
surgical technique. We present a retrospective study about
the cephalic screws positioning in 400 pertrochanteric fractures
treated with gamma nail. We also assessed the tip-apex
distance and impaction of the fracture, looking for any relationships
between them and the failure of the implant. In our
series, 37.7% of screw failures occurs in the anterior-superior
localization, and 30.7% in posterior-inferior localization. All
cut-outs were produced in cases with a Tip Ápex distance larger
than 28 mm. The mean impaction in stable fractures was
2.27 mm and in unstable fractures was 8.26 mm.
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