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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1426307

Key Factors for Increased Tip-apex Distance When Treating Intertrochanteric Fractures with InterTAN nails

Provisionally accepted
Naifeng Zhu Naifeng Zhu 1Lianxia Wu Lianxia Wu 2Xiaofeng Han Xiaofeng Han 3Zhonglai Qian Zhonglai Qian 1*
  • 1 Department of orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, China
  • 2 Population Research Institute, School of Social Development, East China Normal University, Shanghai, China
  • 3 Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: The tip-apex distance is a key factor in predicting implant cut-out after intramedullary fixation for intertrochanteric fractures. This study aimed to evaluate the factors associated with an increased tip-apex distance when treating intertrochanteric fractures using an InterTAN nail. Methods and Material: We retrospectively analyzed patients with intertrochanteric fractures who underwent InterTAN nail insertion between January 2017 and March 2022 at our hospital. Medical and radiological data were collected. Measurements of preoperative factors and postoperative factors were performed accordingly. Multivariate logistic regression analysis was performed to determine the statistically significant variables of the tip-apex distance.Results: This study included 102 patients with intertrochanteric fractures. The average tip-apex distance measured 22.4±7.1 mm, ranging from 9.3 to 48.0 mm. The length of the femoral neck on the non-fractured side, lag screw placement in the sagittal plane (center-inferior, superior) and coronal plane (posterior), and the angle between the line of the proximal nail axis and the femoral long axis were identified to be statistically significant factors for the tip-apex distance.To obtain a shorter tip-apex distance, we recommend a medial trochanteric entry point to minimize the angle between the line of the proximal nail axis and the femoral long axis. Additionally, sufficiently deep central insertion of the lag screw was advised in both the sagittal and coronal planes.

    Keywords: Tip-apex distance, Cut-out, Implant failure, InterTAN, Intertrochanteric fracture

    Received: 03 Jul 2024; Accepted: 16 Oct 2024.

    Copyright: © 2024 Zhu, Wu, Han and Qian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhonglai Qian, Department of orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.