Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study
Abstract Background Perioperative peri-implant fractures (PPIFs) pose infrequent yet significant challenges in orthopedic surgery, particularly in the context of femoral pertrochanteric fractures (FPF) treated with proximal femoral nail antirotation 2 (PFNA-2) nails. PPIFs can lead to prolonged reco...
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BMC
2024-11-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08085-7 |
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| author | Jiun-Jen Yang Yung-Heng Hsu Ying-Chao Chou Ping‑Jui Tsai Chang-Heng Liu Yi-Hsun Yu |
| author_facet | Jiun-Jen Yang Yung-Heng Hsu Ying-Chao Chou Ping‑Jui Tsai Chang-Heng Liu Yi-Hsun Yu |
| author_sort | Jiun-Jen Yang |
| collection | DOAJ |
| description | Abstract Background Perioperative peri-implant fractures (PPIFs) pose infrequent yet significant challenges in orthopedic surgery, particularly in the context of femoral pertrochanteric fractures (FPF) treated with proximal femoral nail antirotation 2 (PFNA-2) nails. PPIFs can lead to prolonged recovery and may necessitate re-osteosynthesis in severe cases. Despite the effectiveness of PFNA-2 in the management of FPFs, our understanding of PPIFs in this specific context remains limited. This study aimed to elucidate the factors contributing to PPIFs in patients with PFNA-2-treated FPF. Methods In this retrospective analysis spanning from 2019 to 2022, patients with FPF treated with PFNA-2 nails were examined. Demographic data, fracture characteristics, and radiological parameters were collected, along with details of the PPIF management strategies and rehabilitation protocols. Radiological assessments included femoral morphology measurements and reduction and fixation quality evaluation. The area under the curve (AUC) was analyzed in this specific group. Results Among 157 patients, 3.2% experienced acute PPIFs managed conservatively with successful union without secondary surgical intervention. Younger age and increased femoral isthmus diameter (DI) emerged as significant predictors of PPIFs in the univariate regression analyses (P = 0.01). The AUCs for age (65.5 years) and DI (1.4 cm) were 0.78 and 0.79, respectively, indicating moderate accuracy. Conclusions Although PFNA-2 nails are reliable in managing FPFs, the persistence of PPIFs emphasizes their complex causes. This study highlights that younger age and increased femoral DI are crucial factors for PPIF occurrence in patients with PFNA-2-treated FPF. Conservative treatment with delayed weight-bearing ambulation may be effective in treating these fractures. |
| format | Article |
| id | doaj-art-36fb44c7a4ab4d548481fc26df0dbfec |
| institution | OA Journals |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-36fb44c7a4ab4d548481fc26df0dbfec2025-08-20T02:32:56ZengBMCBMC Musculoskeletal Disorders1471-24742024-11-0125111010.1186/s12891-024-08085-7Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective studyJiun-Jen Yang0Yung-Heng Hsu1Ying-Chao Chou2Ping‑Jui Tsai3Chang-Heng Liu4Yi-Hsun Yu5Division of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalDivision of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalDivision of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalDivision of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalDivision of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalDivision of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial HospitalAbstract Background Perioperative peri-implant fractures (PPIFs) pose infrequent yet significant challenges in orthopedic surgery, particularly in the context of femoral pertrochanteric fractures (FPF) treated with proximal femoral nail antirotation 2 (PFNA-2) nails. PPIFs can lead to prolonged recovery and may necessitate re-osteosynthesis in severe cases. Despite the effectiveness of PFNA-2 in the management of FPFs, our understanding of PPIFs in this specific context remains limited. This study aimed to elucidate the factors contributing to PPIFs in patients with PFNA-2-treated FPF. Methods In this retrospective analysis spanning from 2019 to 2022, patients with FPF treated with PFNA-2 nails were examined. Demographic data, fracture characteristics, and radiological parameters were collected, along with details of the PPIF management strategies and rehabilitation protocols. Radiological assessments included femoral morphology measurements and reduction and fixation quality evaluation. The area under the curve (AUC) was analyzed in this specific group. Results Among 157 patients, 3.2% experienced acute PPIFs managed conservatively with successful union without secondary surgical intervention. Younger age and increased femoral isthmus diameter (DI) emerged as significant predictors of PPIFs in the univariate regression analyses (P = 0.01). The AUCs for age (65.5 years) and DI (1.4 cm) were 0.78 and 0.79, respectively, indicating moderate accuracy. Conclusions Although PFNA-2 nails are reliable in managing FPFs, the persistence of PPIFs emphasizes their complex causes. This study highlights that younger age and increased femoral DI are crucial factors for PPIF occurrence in patients with PFNA-2-treated FPF. Conservative treatment with delayed weight-bearing ambulation may be effective in treating these fractures.https://doi.org/10.1186/s12891-024-08085-7Pertrochanteric fracturesPeri-implant fracturesProximal femoral nail antirotation 2Intramedullary nailOsteosynthesis |
| spellingShingle | Jiun-Jen Yang Yung-Heng Hsu Ying-Chao Chou Ping‑Jui Tsai Chang-Heng Liu Yi-Hsun Yu 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 Pertrochanteric fractures Peri-implant fractures Proximal femoral nail antirotation 2 Intramedullary nail Osteosynthesis |
| title | Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study |
| title_full | Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study |
| title_fullStr | Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study |
| title_full_unstemmed | Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study |
| title_short | Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study |
| title_sort | assessing potential factors leading to perioperative peri implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2 a retrospective study |
| topic | Pertrochanteric fractures Peri-implant fractures Proximal femoral nail antirotation 2 Intramedullary nail Osteosynthesis |
| url | https://doi.org/10.1186/s12891-024-08085-7 |
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