Use of Cemented TFNA Nail Augmentation in the Treatment of Trochanterian Rock Fractures

University Hospital, Brest61 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

the Cement Augmented Screws of TFNA Nails

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

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).

Locations (1)

Outcomes

Primary Outcomes

Fixation failure rate (cut-out or cut-through)

On X rays

Time frame: change at 3 and 6 postoperative months

Secondary Outcomes

Visual Analogue Scale score

the minimum is 0 and maximum 10, higher scores mean a worse outcome.

Time frame: at 3 and 6 postoperative months

analysis evaluating quality of reduction

On X rays

Time frame: once

Augmentation volume

Time frame: once

length of surgery

Time frame: at 3 and 6 postoperative months

radiation exposure

Time frame: once

duration of hospitalisation

Time frame: once

Intraoperative adverse events

Time frame: once

EuroQoL 5-Dimensions score

the minimum is 5 and maximum 15, higher scores mean a worse outcome.

Time frame: change at 3 and 6 postoperative months

Parker Mobility Score

the minimum is 0 and maximum 9, higher scores mean a better outcome.

Time frame: at 3 and 6 postoperative months

Harris Hip Score

the minimum is 0 and maximum 100, higher scores mean a betteroutcome.

Time frame: at 3 and 6 postoperative months

the tip-apex distance

On X rays

Time frame: once

TFNA screw position

On X rays

Time frame: once

distribution of cement on either side of the cervicocephalic screw

On X rays

Time frame: once

postoperative complications

Time frame: at 3 and 6 postoperative months

the need for revision surgery

Time frame: at 3 and 6 postoperative months