André Luiz Pellacani França¹*, Matheus Silva Teixeira², Ana Valéria Bruneti Rigolino³, Marcelo Itiro Takano⁴, Richard Armelin Borger⁴ and Roberto Dantas Queiroz⁵

¹Post-Graduated Degree in Hip Surgery at Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), Vitória Apart Hospital, Serra/ES, Brasil
²Post-Graduated Degree in Sports Medicine at Centro Universitário Ingá (UNINGA), Hospital do Servidor Público Estadual de São Paulo (HSPE-SP), São Paulo/SP, Brasil
³Post-Graduated Degree in Orthopaedic Oncology at Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), Hospital do Servidor Público Estadual de São Paulo (HSPE-SP), São Paulo/SP, Brasil
⁴Post-Graduated Degree in Hip Surgery at Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), Hospital do Servidor Público Estadual de São Paulo (HSPE-SP), São Paulo/SP, Brasil
⁵Post-Graduated Degree in Hip Surgery at Universidade Federal de São Paulo (UNIFESP), Universidade Federal de São Paulo, São Paulo/SP, Brasil

*Corresponding Author: André Luiz Pellacani França, Post-Graduated Degree in Hip Surgery at Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo (IAMSPE), Vitória Apart Hospital, Serra/ES, Brasil.

Received: February 01, 2023; Published: February 17, 2023

Abstract

Objective: Evaluate the influence in the position of the anti-rotational device in cephalomedullary nails and its influences on the consolidation of trochanteric fractures.

Methods: Retrospective case series comprising 58 patients with unstable trochanteric fractures that underwent osteosynthesis with cephalomedullary nail and anti-rotational device. Were analyzed the radiographs of the pelvis and ipsilateral hip osteosynthesis with 6 months postoperatively and compared to initial. The radiographic parameters used were tip-apex index (TAD), the positioning of the sliding screw in relation to the central axis of the femoral neck, the angle of reduction and fracture healing.

Results: From the 58 patients selected for initial postoperative examination, 15 (26%) died, 6 (10%) lost the thread of the treatment and 37 (64%) were reassessed. Most of them were female patients, beteween the ninth and tenth decade of life. It was observed that 31 (84%) fractures were consolidated, while 6 (16%) patients had their fractures not yet consolidated. The reduction angle in healed fractures was 129o and in non-healed were 136o. In these, the position of the sliding screw was far from the central axis of femoral neck.

Conclusion: The fixation of trochanteric fractures with cephalomedullary nail with anti-rotational device is safe. The reduced fractures with valgus above 135 ° showed higher rates of nonunion. In these cases the position of the sliding screw was lower than ideal to fit the anti-rotational device, which may have affected negatively the fracture healing.

Keywords: Transtrochanteric Fractures; Post OP Complications; Pseudoarthrosis; Cefalomedular Nails; Anti-Rotational Screw

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Citation

Citation: André Luiz Pellacani Franca., et al. “Analysis of the use of the Anti-Rotational Device in Cephalomedullary Nail and its Implications in Fractures of the Proximal Femur”. Acta Scientific Orthopaedics 6.3 (2023): 140-147.

Copyright

Copyright: © 2023 André Luiz Pellacani Franca., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.