The failure mode of almost all defect model femora was consistent with that of the simulated type of intertrochanteric fractures. Paired t test was performed to assess the differences between two groups. The strains of each specimen were recorded at load levels of 350, 700, and 1800 N and the failure load. According to a single-leg stance model, an axial loading was applied, and the strain distribution was measured before and after PFNA implantation. The major objective of the present study is to investigate the differences in the load and strain changes in the intertrochanteric region of human cadaveric femora between the loss of medial or lateral wall and after treatment with proximal femoral nail antirotation (PFNA).Īfter measuring the geometry of the proximal femur region and modeling the medial or lateral wall defect femoral models, six pairs of freshly frozen human femora were randomly assigned in the medial or lateral wall group. 001).ĬalTAD is the key evaluation tool for measurement of cephalic fixation position for predicting implant failures in geriatric ITF patients treated with single-screw CMN after obtaining the acceptable reduction. The ROC analysis showed that the best cut-off value of CalTAD was 23.76 mm with a sensitivity of 77.8% and specificity of 72.3% (area under the curve, AUC =.775 P =. We found that TAD (odds ratio (OR)=1.149 95% confidence interval (CI), 1.00–1.32 P=.046) and CalTAD (OR=1.140 95% CI, 1.00–1.30 P=.037) were risk factors for implant failures by univariate analysis, while only CalTAD (OR=1.200 95% CI, 1.032–1.395 P=.018) was the independent risk factor for implant failures by multivariate analysis. There were six cases of cut-out and three of pending cut-out.
Of the 74 patients, nine cases were observed with implant failures. Seventy-four ITF patients treated with single-screw CMN fixation after obtaining the acceptable reduction were enrolled in this study. We measured the geriatric ITF patients undergoing single-screw cephalomedullary nailing (CMN) fixation surgery after obtaining the acceptable reduction (including anatomical reduction and positive medial cortex support reduction) in our treatment group between September 2016 and March 2020 by using four kinds of cephalic fixation position evaluation tools including Cleveland zone system, Parker’s ratio index, tip–apex distance (TAD), calcar-referenced TAD (CalTAD), and analyzed which were the key evaluation tools for measurement of cephalic fixation position for prediction of implant failures in geriatric ITF patients with internal fixations. To discover the key evaluation tool of the cephalic fixation position for predicting implant failures in geriatric intertrochanteric fracture (ITF) patients treated with internal fixations after achieving an acceptable reduction.
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