Tip Apex distance as a predictor of failure in intertrochanteric fractures treated with PFNA

Dr. Vikram Sharma; Dr. Vivek Chandak

Volume : IX, Issue : IV, April - 2020

Tip Apex distance as a predictor of failure in intertrochanteric fractures treated with PFNA

Dr. Vikram Sharma, Dr. Vivek Chandak

Abstract :

A tip apex distance of 25 mm or less has been shown to be a predictor of prevention of lag screw cut out leading to greater success of fixation, when DHS is used to treat intertrochanteric fractures. This study was aimed to determine whether tip-apex distance (TAD) was also useful as a predictor when proximal femoral nails (PFNA) is used to treat intertrochanteric fractures. A total of 103 patients were included in this study. The TAD values were determined by post operative radiographs.92 patients had adequate follow up till union of the fracture or cut out leading to implant failure. All 92 patients had intertrochanteric hip fractures. Overall, 19 patients (20.6%) had lag screw cut-out. The average TAD of the patients who did not cut-out was 21 mm, compared to 34 mm for those who did. The percentage of cut-outs correlated directly to both the severity of intertrochanteric fractures and the TAD. Surgeons should try and keep the TAD below 25mm in PFNA as this is likely to prevent complication.