Clin Orthop Surg.  2019 Mar;11(1):36-42. 10.4055/cios.2019.11.1.36.

The Effect of Valgus Reduction on the Position of the Blade of the Proximal Femoral Nail Antirotation in Intertrochanteric Hip Fractures

Affiliations
  • 1Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Korea.
  • 2Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. ybs58@paik.ac.kr
  • 3Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The purpose of this study was to evaluate the quantitative association between the degree of reduction and the position of the blade of the proximal femoral nail antirotation (PFNA) in intertrochanteric hip fractures.
METHODS
From March 2009 to April 2015, 530 patients treated with PFNA for intertrochanteric hip fractures were retrospectively reviewed. Patients were divided into a valgus reduced group (group 1) and a non-valgus reduced group (group 2), and the "valgus reduced" was defined as valgus reduction over 5°. We compared the calcar referenced tip-apex distance (calTAD) and the area between the blade of PFNA and the medial cortex of the femoral neck between the two groups.
RESULTS
The calTAD was measured as 22.5 ± 4.1 mm in group 1 and 24.8 ± 3.8 mm in group 2 (p < 0.05). The area between the blade and the medial femoral neck was measured as 135.5 ± 49.8 mm2 in group 1 and 145.1 ± 54.8 mm2 in group 2 (p = 0.074). The area corrected for the length difference in the femoral neck was 0.55 ± 0.16 in group 1 and 0.79 ± 0.19 in group 2 (p < 0.05).
CONCLUSIONS
Valgus reduction resulted in less calTAD and inferior position of the blade at the femoral neck in the treatment of intertrochanteric hip fractures with PFNA.

Keyword

Femur; Intertrochanteric fractures; Intramedullary nailing; Fracture closed reduction

MeSH Terms

Femur
Femur Neck
Fracture Fixation, Intramedullary
Hip Fractures*
Hip*
Humans
Retrospective Studies
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