Background: Cortical impingement is a common complication after cephalomedullary nailing, but the evidence about its consequences is very limited. The aim of this study was to assess the clinical implications of cortical impingement on patients treated with cephalomedullary nails.
Methods: A cohort study was carried out at a Level I academic Institution with consecutive patients treated with cephalomedullary nails during 2010 and 2013. Demographic and nail variables were recorded as well as cortical impingement was determined on the radiographs. Clinical outcomes such as pain, femoral fractures, and delayed or nonunion of the fracture were detected during the follow-up. The follow-up was divided into short- (6-12 months), medium- (12.1-36 months), and long-term follow-up (≥36.1months). Descriptive statistics were used, and Chi-square or Fisher's exact tests measured the association between categorical variables. The Mann-Whitney U test was performed to evaluate differences between cortical impingement in terms of pain, and pain and the follow-up categories.
Results: A total of 119 patients were analyzed with a mean age of 74.8 years±17.1, and a mean follow-up of 23.5 months±12.1. Overall the pain was present in 61 (51.2%) cases, and it was observed in 28/59 (47.4%) and 33/60 (55%) of the patients with presence or absence of cortical impingement respectively. There was not a statistically significant association between cortical impingement and pain (p=0.20), neither differences were detected between pain and the follow-up groups (p=0.48). Out of 59 cases with cortical impingement, femoral fractures were observed in two patients (3.3%), and delayed union of the fractures was seen in two patients who did not present impingement. Since patients with delayed union received treatment as soon as it was diagnosed, no cases of nonunion of fractures were identified.
Conclusions: Cortical impingement of the anterior cortex of the femur was not associated with the presence of pain, so that other causes should be assessed to explain the pain after 6 months of being treated with a cephalomedullary nail. Femoral fractures, and delayed union or nonunion of the fracture may occur theoretically in patients with cortical impingement.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.injury.2016.06.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
β-Asarone regulates microglia polarization to alleviate TBI-induced nerve damage via Fas/FasL signaling axis.
Hum Cell
December 2024
Department of Integrated Traditional Chinese and Western Medicine, Xiangya Hospital, Central South University, Jiangxi Hospital, National Reginal Center for Neurological Disease, Honggutan District, No.266 Fenghe North Avenue, Nanchang, 330038, Jiangxi, China.
Acute injury and secondary injury caused by traumatic brain injury (TBI) seriously threaten the health of patients. The purpose of this study was to investigate the role of β-Asarone in TBI-induced neuroinflammation and injury. In this work, the effects of β-Asarone on nerve injury and neuronal apoptosis were investigated in mice with TBI by controlled cortical impingement.
View Article and Find Full Text PDFArticle Synopsis
- *Researchers reviewed data from 100 patients who underwent hip arthroscopy for FAI, measuring their alpha angles before and after surgery, and assessing the reliability of these measurements.
- *Results showed a significant difference between the outer alpha angle (average 77.0°) and the inner alpha angle (average 46.4°), indicating that the imaging technique could effectively guide how much bone needs to be resected for optimal outcomes.
Anterior Cortical Impingement With 240 mm Cephalo-Medullary Nail (PFN and PFNA-2) in Intertrochanteric Femur Fracture Fixation in the Indian Population: A Problem Statement.
Cureus
August 2024
Orthopaedics, N. K. P. Salve Institute of Medical Sciences (NKPSIMS) and Research Centre (RC) Lata Mangeshkar Hospital, Nagpur, IND.
Trochanteric fractures are common in the elderly population, and their incidence increases twice every decade after age 50. Intramural fixation has achieved good clinical efficacy in the treatment of unstable trochanteric fractures, but there have been complications reported in the literature in the Asian population. Most complications arise from a mismatch between the increase in the anterior femoral bow with advancing age and the proximal femoral nails (PFN) on the market, which still have straight designs on the sagittal plane.
View Article and Find Full Text PDFDoes Mal-alignment of the CLS Spotorno Femoral Stem Correlate with Functional Outcome of Patients Undergoing Total Hip Arthroplasty? An Evaluation at Mid-term Follow Up.
Indian J Orthop
October 2024
Department of Orthopaedics, Nehru Hospital, PGIMER, Chandigarh, 160012 India.
Background: The straight and thin design of the CLS Spotorno stem makes it prone for coronal plane mal-alignment, with potential for cortical impingement; reactive osteogenesis and thigh pain have been documented in this situation with some stems. The literature is scarce about the effect of distal mal-alignment with this particular stem, and its relationship with thigh pain, functional outcomes and stem survival. We assessed functional outcomes with incidence of varus/valgus CLS stem alignment, and correlated stem subsidence of these thin stems with hip scores.
View Article and Find Full Text PDFModified Dunn Procedure for Open Reduction of Chronic Slipped Capital Femoral Epiphysis.
JBJS Essent Surg Tech
July 2024
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Article Synopsis
- Abnormal femoral head shape from slipped capital femoral epiphysis (SCFE) can lead to hip problems like femoroacetabular impingement and early osteoarthritis, making surgical correction important to restore hip anatomy.
- The modified Dunn procedure offers a surgical approach that aims to correct the anatomy of the hip without damaging the blood supply to the femoral head, reducing the risk of osteonecrosis.
- The procedure involves a careful dislocation of the hip and meticulous shaping of bones while maintaining blood vessel integrity, allowing for effective repositioning and fixation of the femoral head.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!