Accuracy of Preoperative Planning Helical Blade Length during Treatment of Intertrochanteric Hip Fractures with Trochanteric Fixation Nail System.

Q3 Dentistry
Nathaniel J Starcher, Daniel T DeGenova, Matthew T Glazier, Klay B Miller, Peter Spencer, Vishvam Mehta, Nick Blair, Mallory Faherty, Benjamin C Taylor
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引用次数: 0

Abstract

Intertrochanteric hip fractures are commonly treated with cephalomedullary nailing. One time-consuming aspect of the procedure is intraoperatively measuring the helical blade length. This investigation sought to determine if preoperative imaging can be reliably used to predict helical blade length and therefore reduce operative time accurately. This was a single-center, single-surgeon retrospective chart review. All subjects were operated on by the senior author at a single urban level-1 trauma center. Each patient underwent cephalomedullary nailing using a helical blade. The medical records were reviewed for demographic, imaging, and operative data. Two raters preoperatively recorded head element length, subsequently estimated helical blade implant sizes, and actual implant length used intraoperatively. In total, 134 patients were analyzed. The results demonstrated that radiographs (R2 = 0.337, p < 0.001) and computed tomography (CT) imaging (R2 ≥ 0.435, p < 0.001) could not reliably predict helical blade length, and that radiographs were more accurate than CT scans in predicting actual implant size (p < 0.001). Preoperative imaging modalities predicted the exact size only 23.8% of the time using radiographs and 17.2% of the time using CT. Preoperative helical blade implant size was estimated accurately 24% of the time. However, raters were successful in estimating the length of the helical blade within three sizes. We demonstrate that preoperative imaging modalities are unable to accurately predict helical blade length.

股骨粗隆内固定钉系统治疗股骨粗隆间骨折时术前规划螺旋刀片长度的准确性。
股骨粗隆间骨折通常采用头髓内钉治疗。其中一个耗时的方面是术中测量螺旋叶片长度。本研究旨在确定术前影像是否可以可靠地预测螺旋叶片长度,从而准确地减少手术时间。这是一项单中心、单外科医生的回顾性研究。所有受试者均由资深作者在单一的城市一级创伤中心进行手术。每位患者均使用螺旋刀片进行头髓内钉。对医疗记录进行了人口统计学、影像学和手术资料的审查。两名评分者术前记录头单元长度,随后估计螺旋叶片种植体大小,以及术中使用的实际种植体长度。总共分析了134例患者。结果表明,x线片(R2 = 0.337, p < 0.001)和计算机断层扫描(CT)成像(R2≥0.435,p < 0.001)不能可靠地预测螺旋叶片长度,而x线片在预测实际种植体尺寸方面比CT扫描更准确(p < 0.001)。术前影像学对肿瘤大小的准确预测,x线片和CT分别为23.8%和17.2%。术前螺旋刀片植入物的大小估计准确率为24%。然而,评分者成功地估计了三种尺寸内螺旋叶片的长度。我们证明术前成像模式无法准确预测螺旋叶片长度。
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来源期刊
CiteScore
1.20
自引率
0.00%
发文量
46
期刊介绍: MEDICAL IMPLANTS are being used in every organ of the human body. Ideally, medical implants must have biomechanical properties comparable to those of autogenous tissues without any adverse effects. In each anatomic site, studies of the long-term effects of medical implants must be undertaken to determine accurately the safety and performance of the implants. Today, implant surgery has become an interdisciplinary undertaking involving a number of skilled and gifted specialists. For example, successful cochlear implants will involve audiologists, audiological physicians, speech and language therapists, otolaryngologists, nurses, neuro-otologists, teachers of the deaf, hearing therapists, cochlear implant manufacturers, and others involved with hearing-impaired and deaf individuals.
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