ArticleChinese journal of traumatology = Zhonghua chuang shang za zhi2017
Z-effect after intramedullary nailing systems for trochanteric femur fractures.
Article in Chinese journal of traumatology = Zhonghua chuang shang za zhi, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 11 citations in OpenAlex.
- Healing Against the Odds: Successful Bone Union in Intertrochanteric Femur Fracture Despite Z-Effect and Implant Failure.Journal of orthopaedic case reports · 2025Article
- Cut-Through versus Cut-Out: No Easy Way to Predict How Single Lag Screw Design Cephalomedullary Nails Used for Intertrochanteric Hip Fractures Will Fail?Hip & pelvis · 2023Article
- Subtrochanteric femoral fractures and intramedullary nailing complications: a comparison of two implants.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Article
- TresLock for Unstable Proximal Femoral Fractures: Morphological Compatibility and Clinical Results: A Case Series.Journal of orthopaedic case reports · 2022Article
- Which implant is better for beginners to learn to treat geriatric intertrochanteric femur fractures: A randomised controlled trial of surgeons, metalwork, and patients.Journal of orthopaedic translation · 2020Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to investigate the incidence of Z-effect after dual lag screw intramedullary nailing systems and risk factors contributing to this effect. We hypothesized that long nails provide more neck strength due to a longer lever than short nails and are therefore less likely to develop a misbalance of a higher head compressive strength than neck compressive strength.
methodsIn this retrospective cohort study 103 patients treated operatively with a dual lag screw intramedullary nailing device for (sub)trochanteric hip fracture were included. We analysed patient charts regarding patient and operation characteristics. Furthermore we conducted radiologic measurements within the 2-year follow-up period to investigate the quality of fracture fixation, implant failure and predictors for Z-effect. The re-operation risk was investigated with multivariate regression analysis.
resultsThe incidence of (reversed) Z-effect in this study was 9% (n = 80); 6 out of 7 Z-effects occurred in the short nail group, which was not significant. Patients who were treated with a long nail had a significant larger number of complications in comparison with the short nail group (median 2 vs 0.5, p = 0.001). The long nail group received more often erythrocytes blood transfusions (82% vs 31%, p < 0.01) and had a longer hospital stay (13 vs 21 days, p < 0.05). Migration of lag screws (p <0.05) and unstable fracture type (p < 0.05), were risk factors for re-operation. The re-operation rate within 2 year after surgery was 21%, of which one fourth was due to a Z-effect.
conclusionThe nail length was not associated with the development of a Z-effect. Migration of lag screws after intramedullary nailing is common and a risk factor for re-operation.
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