ArticleActa orthopaedica et traumatologica turcica2023
A new scoring system for predicting cut-out risk in patients with intertrochanteric femur fractures treated with proximal femoral nail anti-rotation.
Article in Acta orthopaedica et traumatologica turcica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed.
- Lag screw cutout risk factors in geriatric intertrochanteric femur fractures.BMC geriatrics · 2026Article
- Article
- 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
- 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
- Evaluating polymethylmethacrylate (PMMA) augmentation in cephalomedullary nail fixation of hip fractures: a step towards evidence-based patient selection criteria.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 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
- Evaluation of Risk Factors for Revision Surgery After Proximal Femoral Nailing for Intertrochanteric Fractures.Medicina (Kaunas, Lithuania) · 2025Article
- The positioning of cephalon medullary nailing correlated with hidden blood loss during the perioperative period in patients with intertrochanteric fractures: A retrospective study.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Predicting mechanical complications in proximal femoral nailing for elderly patients: a radiological scoring system based on a single-centre retrospective cohort with 586 cases.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Effectiveness of the Dorr index in predicting implant failure before proximal femoral nail application.Joint diseases and related surgery · 2025Article
- Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study.BMC musculoskeletal disorders · 2024Article
- Predictive value of tip-apex distance and calcar-referenced tip-apex distance for cut-out in 398 femoral intertrochanteric fractures treated in a private practice with dynamic intramedullary nailing.Frontiers in surgery · 2024Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objectives of this study were to: (1) determine all the potential risk factors defined in the literature for cut-out after proximal femoral nail anti-rotation in managing intertrochanteric fractures and (2) make a reliable prediction about the likelihood of cut-out by developing a quantitative scoring system.
methodsFour hundred eighty patients who were operated on for an intertrochanteric femur fracture were included in the study. The patients were evaluated retrospectively. Radiological parameters known to affect cut-out, including tip apex distance (TAD), calcarreferenced TAD (CalTAD), and reduction quality, were also used to evaluate the patients. Additionally, the classification of the fracture according to the cortical thickness index for osteoporosis, the Charlson comorbidity index for additional comorbidities, and the Arbeitsgemeinschaft Für Osteosynthesefragen classification were evaluated.
resultsThe cut-out rate among all patients was 7.2%. Cut-out risk could be predicted by gender, TAD, CalTAD, and reduction quality. Female gender, TAD > 29.45, CalTAD > 31.75, and acceptable or poor reduction quality significantly increased the cut-out risk. Based on the chi-square analysis, it was determined that there was a significant relationship between the cut-out risk and the variables of TAD, CalTAD, reduction quality, gender, and fracture type (P=.000, P=.000, P=.000, P=.008, P=.016, respectively). Logistic regression analysis showed a strong correlation between the newly developed scoring system and the risk of cut-out. The risk of cut-out increased 8.1 times in individuals with a score of more than 2 (P < .001).
conclusionFemale gender, TAD > 29.45, CalTAD > 31.75, and acceptable or poor reduction quality are the parameters found to be significant in determining the cut-out risk. With the newly developed scoring system, risks can be calculated for all situations that may occur according to the scores obtained by the patients. The cut-out risk increases significantly in patients with a score above 2 points. LEVEL OF EVIDENCE: Level III, Diagnostic Study.
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