Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?

Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to...

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Main Authors: Goh, Kian Liang, Zakaria@Mohamad, Zamzuri, Sharifudin, Mohd Ariff, Mohamed Amin, Mohamed Azril
Format: Article
Language:English
Published: Faculty of Medicine, International Islamic University Malaysia 2016
Subjects:
Online Access:http://irep.iium.edu.my/50898/
http://irep.iium.edu.my/50898/
http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf
id iium-50898
recordtype eprints
spelling iium-508982016-07-28T01:52:29Z http://irep.iium.edu.my/50898/ Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? Goh, Kian Liang Zakaria@Mohamad, Zamzuri Sharifudin, Mohd Ariff Mohamed Amin, Mohamed Azril RD701 Orthopedics Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuab Faculty of Medicine, International Islamic University Malaysia 2016-06 Article PeerReviewed application/pdf en http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf Goh, Kian Liang and Zakaria@Mohamad, Zamzuri and Sharifudin, Mohd Ariff and Mohamed Amin, Mohamed Azril (2016) Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure? International Medical Journal Malaysia, 15 (1). pp. 31-34. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/Volume%2015%20No%201/original_article/Vol15No1JUNE-2016-031-034.pdf
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic RD701 Orthopedics
spellingShingle RD701 Orthopedics
Goh, Kian Liang
Zakaria@Mohamad, Zamzuri
Sharifudin, Mohd Ariff
Mohamed Amin, Mohamed Azril
Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
description Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuab
format Article
author Goh, Kian Liang
Zakaria@Mohamad, Zamzuri
Sharifudin, Mohd Ariff
Mohamed Amin, Mohamed Azril
author_facet Goh, Kian Liang
Zakaria@Mohamad, Zamzuri
Sharifudin, Mohd Ariff
Mohamed Amin, Mohamed Azril
author_sort Goh, Kian Liang
title Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
title_short Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
title_full Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
title_fullStr Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
title_full_unstemmed Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
title_sort intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
publisher Faculty of Medicine, International Islamic University Malaysia
publishDate 2016
url http://irep.iium.edu.my/50898/
http://irep.iium.edu.my/50898/
http://irep.iium.edu.my/50898/2/Vol15No1JUNE-2016-031-034.pdf
first_indexed 2023-09-18T21:12:02Z
last_indexed 2023-09-18T21:12:02Z
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