The effectiveness of fixation of hydroxyapatite-coated helical blade in preventing of the cut-out observed in treatment with proximal femoral nail of fractures of the femur intertrochanteric in elderly

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dc.contributor.authorTosun, Haci Bayram
dc.contributor.authorUludag, Abuzer
dc.contributor.authorSerbest, Sancar
dc.contributor.authorCicek, Necati
dc.contributor.authorDemir, Sukru
dc.date.accessioned2025-01-21T16:33:41Z
dc.date.available2025-01-21T16:33:41Z
dc.date.issued2023
dc.departmentKırıkkale Üniversitesi
dc.description.abstractBACKGROUND: This study aimed to retrospectively evaluate the effectiveness of hydroxyapatite-coated (HA-coated) implants and other caput-collum implants in preventing cut-out observed in treatment with proximal femoral nail (PFN) of intertrochanteric femur fractures in elderly patients.METHODS: A total of 98 consecutive patients (56 males and 42 females; mean age: 79.42 (61-115) years) treated with three differ-ent PFNs for intertrochanteric femoral fractures were retrospectively examined. The mean of the follow-up period was 7.87 (4-48) months. It was used a threaded lag screw in 40 patients, an HA-coated helical blade in 28 patients and a non-coated helical blade in 30 patients for PFN. The reduction quality, fracture type, and radiological outcomes among all groups were evaluated.RESULTS: Unstable type was seen in 50 (52.1%) patients according to AO Foundation/Orthopedic Trauma Association fracture classi-fication. An acceptable-good reduction quality was seen in 87 (88.8%) of all patients. The average of tip-apex distance (TAD) value was 27.61 mm, calcar-referenced TAD (CalTAD) value was 28.72 mm, caput-collum diaphyseal angle was 128,degrees Parker's anteroposterior ratio was 46.36%, and Parker's lateral ratio was 46.82%. The best suitable implant position was observed in 49 (50%) patients. Cut-out was observed in 7 (7.14%) patients, and secondary varus displacement of more than 10 degrees was observed in 12 (12.24%) patients. Correlation analysis and multivariate logistic regression analysis showed a significant difference between HA-coated and other implants in cut-out. Furthermore, implant type was the strongest predictive factor for cut-out complications in the multivariate logistic regression analysis.CONCLUSION: HA-coated implants may reduce the long-term cut-out risk due to increased osteointegration and bone ingrowth in elderly patients with intertrochanteric femoral fractures with poor bone quality. However, this alone is not enough; a suitable screw position, optimal TAD values, and excellent reduction quality are other important factors.
dc.identifier.doi10.14744/tjtes.2022.78678
dc.identifier.endpage388
dc.identifier.issn1306-696X
dc.identifier.issn1307-7945
dc.identifier.issue3
dc.identifier.pmid36880615
dc.identifier.scopus2-s2.0-85149999152
dc.identifier.scopusqualityQ3
dc.identifier.startpage379
dc.identifier.trdizinid1189480
dc.identifier.urihttps://doi.org/10.14744/tjtes.2022.78678
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay1189480
dc.identifier.urihttps://hdl.handle.net/20.500.12587/23834
dc.identifier.volume29
dc.identifier.wosWOS:000996087000018
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakTR-Dizin
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherTurkish Assoc Trauma Emergency Surgery
dc.relation.ispartofUlusal Travma Ve Acil Cerrahi Dergisi-Turkish Journal of Trauma & Emergency Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_20241229
dc.subjectCaput-collum implant; cut-out; hydroxyapatite-coated; intertrochanteric femur fractures; proximal femoral nail
dc.titleThe effectiveness of fixation of hydroxyapatite-coated helical blade in preventing of the cut-out observed in treatment with proximal femoral nail of fractures of the femur intertrochanteric in elderly
dc.title.alternativeYaşlılarda intertrokanterik femur kırıklarının proksimal femur çivisi ile tedavisinde gözlenen cut-out’un önlenmesinde hidroksiapatit kaplı helikal blade tespitinin etkinliği
dc.typeArticle

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