Evidence map›Paper›PMID 34052921›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022

Salvage procedure for cut-through after surgical fixation of trochanteric fractures with TFN.

Llano Lionel, Carabelli Guido, Brandariz Rodrigo, Taype Danilo, Barla Jorge, Sancineto Carlos

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed.

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5 · Who and what money

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6 authors.

Llano LionelTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina. lionel.llano@hospitalitaliano.org.ar.ORCID http://orcid.org/0000-0002-9962-837X
Carabelli GuidoTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina.
Brandariz RodrigoTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina.
Taype DaniloTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina.
Barla JorgeTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina.
Sancineto CarlosTrauma Section, Instituto de Ortopedia Y Traumatología "Carlos E. Ottolenghi" Hospital Italiano de, Buenos Aires, Argentina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClosed reduction and fixation using a cephalomedullary nail represents the accepted management of unstable intertrochanteric fractures. Cut-through has been described as a complication associated with the treatment. Although a hip arthroplasty may be the most predictable revision method, a non-prosthetic option can lead to similar results. The objective is to describe a non-prosthetic revision procedure in cases of cut-through.

methodWe performed a retrospective analysis of our Institutional Registry for Hip Fractures in elderly patients (RIAFC) from January 2010 to June 2018 searching for cut-through as a failure after unstable intertrochanteric fracture treatment. REVISION PROCEDURE: (A) Helical blade removal, introduction of structural bone graft (autologous or allograft) as a plug to obliterate the communication to the joint and a new blade insertion. (B) Same as in A but augmenting the blade/head purchase with poly(methyl methacrylate) (PMMA). Before the cement insertion, a radio-opaque solution was instilled to assure lack of joint leakage.

resultsWe evaluated 1616 patients. Sixteen of them presented a cut-through complication (1%). Ten of them were females with an average age for all of 84 years. One patient denied an implant revision and opted for a total joint replacement. In four of the patients, the procedure A was done, 2 of them had a new failure, and an joint arthroplasty was performed. In the B group, only one patient needed a revision to a total hip. The other 10 patients healed uneventfully and did not need any further intervention.

conclusionCut-through revision after fixation of unstable intertrochanteric fractures treated with cephalomedullary nail by blocking of the joint communication and augmenting the head blade purchase with PMMA is a safe and minimal invasive procedure, generates low blood loss and rate of complications and allows bone healing preserving the native joint. LEVEL OF EVIDENCE IV: Nil.

Indexed as

Arthroplasty, ReplacementFracture Fixation, IntramedullaryHip FracturesAged, 80 and overBone NailsFemaleHumansMalePolymethyl MethacrylateRetrospective StudiesTreatment OutcomePolymethyl MethacrylateCement augmentationCut-throughHip fractureRevision surgery

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.