ArticleBone & joint research2017
A six-year retrospective analysis of cut-out risk predictors in cephalomedullary nailing for pertrochanteric fractures: Can the tip-apex distance (TAD) still be considered the best parameter?
Article in Bone & joint research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 89 citations in OpenAlex.
- A novel biomechanical model for reproducing and analysing the causal mechanisms of PFNA "cut-in" phenomenon.Archives of orthopaedic and trauma surgery · 2026Article
- Lag screw cutout risk factors in geriatric intertrochanteric femur fractures.BMC geriatrics · 2026Article
- Comparison of the predictive performance of Chang and Baumgaertner reduction quality criteria for cutout complication in geriatric unstable intertrochanteric femur fractures.BMC musculoskeletal disorders · 2026Article
- Influence of cephalomedullary nail length and caput-collum-diaphyseal angle on tip-apex distance and early mechanical cut-out in trochanteric femur fractures.BMC musculoskeletal disorders · 2026Article
- Independent Risk Factors for Lag Screw Cut-Out: The Role of Open Reduction in Intertrochanteric Fracture Fixation With the Proximal Femoral Nail.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Patient-specific anatomical alignment relative to the contralateral collodiaphyseal angle as an independent predictor of screw cut-out after proximal femoral nailing.Journal of orthopaedic surgery and research · 2026Article
- Inferior Screw Referenced Calcar Tip Apex Distance as the Most Accurate Predictor of Mechanical Cut Out in Dual-Screw Proximal Femoral Nails.Medicina (Kaunas, Lithuania) · 2025Article
- Efficacy of Injectable Calcium Composite Bone Substitute Augmentation for Osteoporotic Intertrochanteric Fractures: A Prospective, Non-Randomized Controlled Study.Journal of clinical medicine · 2025Article
- The Femoral Neck-Shaft Offset: A Key Element in the Reconstruction of Intertrochanteric Fracture.Orthopaedic surgery · 2025Article
- From intracellular drivers to immune modulators: emerging paradigms in oncogenic pathway-directed immunotherapy optimization.Cell communication and signaling : CCS · 2025Review
- Evaluation of reduction quality and implant positioning in intertrochanteric fracture fixation: A review of key radiographic parameters.World journal of orthopedics · 2025Review
- Exploring Appropriate Positioning of the Spiral Blade in Treatment of Subtrochanteric Fractures of the Femur Using Proximal Femoral Nail Antirotation.Orthopaedic surgery · 2025Article
- Clinical Outcomes in the Treatment of Pertrochanteric Femur Fractures: A Retrospective Cohort Study.Journal of personalized medicine · 2025Article
- The effects of the positioning of a bolt in the femoral neck system on the short-term outcomes of middle-aged and young adults with displaced femoral neck fractures.BMC musculoskeletal disorders · 2025Article
- Application of deep learning algorithms in classification and localization of implant cutout for the postoperative hip.Skeletal radiology · 2025Article
- Predicting cut-out in intertrochanteric fractures fixed with cephalomedullary nails: the role of tip-to-apex distance referenced to calcar (calTAD)--A retrospective analysis of 158 cases.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Accuracy of radiographic projections to guide cephalic screw position in pertrochanteric fracture: a cadaveric study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- [Clinical and radiographic factors associated with failure of the dynamic hip screw system].Revista medica del Instituto Mexicano del Seguro Social · 2023Observational
- Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail.Hip & pelvis · 2023Article
- A new scoring system for predicting cut-out risk in patients with intertrochanteric femur fractures treated with proximal femoral nail anti-rotation.Acta orthopaedica et traumatologica turcica · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIntramedullary fixation is considered the most stable treatment for pertrochanteric fractures of the proximal femur and cut-out is one of the most frequent mechanical complications. In order to determine the role of clinical variables and radiological parameters in predicting the risk of this complication, we analysed the data pertaining to a group of patients recruited over the course of six years.
methodsA total of 571 patients were included in this study, which analysed the incidence of cut-out in relation to several clinical variables: age; gender; the AO Foundation and Orthopaedic Trauma Association classification system (AO/OTA); type of nail; cervical-diaphyseal angle; surgical wait times; anti-osteoporotic medication; complete post-operative weight bearing; and radiological parameters (namely the lag-screw position with respect to the femoral head, the Cleveland system, the tip-apex distance (TAD), and the calcar-referenced tip-apex distance (CalTAD)).
resultsThe incidence of cut-out across the sample was 5.6%, with a higher incidence in female patients. A significantly higher risk of this complication was correlated with lag-screw tip positioning in the upper part of the femoral head in the anteroposterior radiological view, posterior in the latero-lateral radiological view, and in the Cleveland peripheral zones. The tip-apex distance and the calcar-referenced tip-apex distance were found to be highly significant predictors of the risk of cut-out at cut-offs of 30.7 mm and 37.3 mm, respectively, but the former appeared more reliable than the latter in predicting the occurrence of this complication.
conclusionThe tip-apex distance remains the most accurate predictor of cut-out, which is significantly greater above a cut-off of 30.7 mm.
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