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Article: Cementation: for better or worse? Interim results of a multi-centre cohort study using a fenestrated spiral blade cephalomedullary device for pertrochanteric fractures in the elderly

TitleCementation: for better or worse? Interim results of a multi-centre cohort study using a fenestrated spiral blade cephalomedullary device for pertrochanteric fractures in the elderly
Authors
KeywordsTFNA
Hip fracture
Intraoperative complications
Fixation failure
Cement augmentation
Issue Date2020
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00402/index.htm
Citation
Archives of Orthopaedic and Trauma Surgery, 2020, Epub 2020-04-25 How to Cite?
AbstractIntroduction: Cephallomedullary nail fixation is currently the most popular treatment for pertrochanteric fractures. Despite continuous improvement in implant design, fixation failures still occur in a concerning number of cases. This study aims to evaluate the effect of cement augmentation of the new-generation Trochanteric Femoral Nail Advanced (TFNA) perforated spiral blade on complications including fixation failure in the elderly population. Materials and methods: We retrospectively evaluated 107 patients aged 65 + treated for pertrochanteric fractures via TFNA between 2015 and 2019 based on whether cementation was used. Baseline demographics, fracture classifications, and reduction quality were compared. Patients with a follow-up of at least 6 months were analyzed for the primary outcome of fixation failure. All patients, regardless of loss to follow-up within 6 months, were analyzed for other complications including mortality. Results: Seventy-six patients (47 cemented, 29 non-cemented) had a minimum follow-up of 6 months (mean 13 months). There were no statistically significant differences between the two treatment groups in terms of patient demographics, ASA or AO/OTA fracture classification, reduction quality, or length of follow-up. There was a lower rate of fixation failure in the cement-augmented (CA) group versus the non-cement-augmented (NCA) group (2.1% vs 13.8%; p = 0.047). No cut-out or cut-through was observed in the CA group. Seven patients had adverse intraoperative events, with a significantly higher rate of fixation failure in these patients (40% vs 2.8%; p = 0.00). There were no statistically significant differences in 30-day mortality (6.3% CA vs 4.3% NCA; p = 0.632) or 3-month mortality (9.5% CA vs 12.8% NCA; p = 0.589). Conclusions: Cementation of TFNA blades may decrease risk of fixation failure, however, the surgeon must be aware of potential complications such as cement leakage into the hip joint and be able to manage them as they arise.
Persistent Identifierhttp://hdl.handle.net/10722/283267
ISSN
2023 Impact Factor: 2.0
2023 SCImago Journal Rankings: 1.036
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYee, DKH-
dc.contributor.authorLau, W-
dc.contributor.authorTiu, KL-
dc.contributor.authorLeung, F-
dc.contributor.authorFang, E-
dc.contributor.authorPineda, JPS-
dc.contributor.authorFang, C-
dc.date.accessioned2020-06-22T02:54:21Z-
dc.date.available2020-06-22T02:54:21Z-
dc.date.issued2020-
dc.identifier.citationArchives of Orthopaedic and Trauma Surgery, 2020, Epub 2020-04-25-
dc.identifier.issn0936-8051-
dc.identifier.urihttp://hdl.handle.net/10722/283267-
dc.description.abstractIntroduction: Cephallomedullary nail fixation is currently the most popular treatment for pertrochanteric fractures. Despite continuous improvement in implant design, fixation failures still occur in a concerning number of cases. This study aims to evaluate the effect of cement augmentation of the new-generation Trochanteric Femoral Nail Advanced (TFNA) perforated spiral blade on complications including fixation failure in the elderly population. Materials and methods: We retrospectively evaluated 107 patients aged 65 + treated for pertrochanteric fractures via TFNA between 2015 and 2019 based on whether cementation was used. Baseline demographics, fracture classifications, and reduction quality were compared. Patients with a follow-up of at least 6 months were analyzed for the primary outcome of fixation failure. All patients, regardless of loss to follow-up within 6 months, were analyzed for other complications including mortality. Results: Seventy-six patients (47 cemented, 29 non-cemented) had a minimum follow-up of 6 months (mean 13 months). There were no statistically significant differences between the two treatment groups in terms of patient demographics, ASA or AO/OTA fracture classification, reduction quality, or length of follow-up. There was a lower rate of fixation failure in the cement-augmented (CA) group versus the non-cement-augmented (NCA) group (2.1% vs 13.8%; p = 0.047). No cut-out or cut-through was observed in the CA group. Seven patients had adverse intraoperative events, with a significantly higher rate of fixation failure in these patients (40% vs 2.8%; p = 0.00). There were no statistically significant differences in 30-day mortality (6.3% CA vs 4.3% NCA; p = 0.632) or 3-month mortality (9.5% CA vs 12.8% NCA; p = 0.589). Conclusions: Cementation of TFNA blades may decrease risk of fixation failure, however, the surgeon must be aware of potential complications such as cement leakage into the hip joint and be able to manage them as they arise.-
dc.languageeng-
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00402/index.htm-
dc.relation.ispartofArchives of Orthopaedic and Trauma Surgery-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI]-
dc.subjectTFNA-
dc.subjectHip fracture-
dc.subjectIntraoperative complications-
dc.subjectFixation failure-
dc.subjectCement augmentation-
dc.titleCementation: for better or worse? Interim results of a multi-centre cohort study using a fenestrated spiral blade cephalomedullary device for pertrochanteric fractures in the elderly-
dc.typeArticle-
dc.identifier.emailYee, DKH: yeedns@hku.hk-
dc.identifier.emailLeung, F: klleunga@hkucc.hku.hk-
dc.identifier.emailFang, E: evanfang@hku.hk-
dc.identifier.emailFang, C: cfang@hku.hk-
dc.identifier.authorityLeung, F=rp00297-
dc.identifier.authorityFang, C=rp02016-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00402-020-03449-9-
dc.identifier.pmid32335758-
dc.identifier.scopuseid_2-s2.0-85084159344-
dc.identifier.hkuros310621-
dc.identifier.volumeEpub 2020-04-25-
dc.identifier.isiWOS:000528656000001-
dc.publisher.placeGermany-
dc.identifier.issnl0936-8051-

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