Proximal femur fractures treatment can involve anterograde nailing with a single or double cephalic screw. An undesirable failure for this fixation is screw cut-out. In a single-screw nail, a tip-apex distance (TAD) greater than 25 mm has been associated with an increased risk of cut-out. The aim of the study was to examine the role of TAD as a risk factor in a cephalic double-screw nail. A retrospective study was conducted on 112 patients treated for intertrochanteric femur fracture with a double proximal screw nail (Endovis BA2; EBA2) from January to September 2021. The analyzed variables were age, sex, BMI, comorbidities, fracture type, side, time of surgery, quality of reduction, pre-existing therapy with bisphosphonate for osteoporosis, screw placement in two different views, and TAD. The last follow-up was at 12 months. Logistic regression was used to study the potential factors of screw cut-out, and receiver operating characteristic curve to identify the threshold value.Aims
Methods
The aim of the study was to test the biomechanical effectiveness of the radiolucent fixator “X-caliber”. For this reason, care was taken to include a heterogeneous group of leg fractures capable of treatment with external fixation. A multi-centre study was organized to taste the biomechanical effectiveness of the radiolucent synthesis device. Our centre was equipped with this external fix-ator, which is preassembled and completely radiolucent. The fixator is manufactured from a carbon fibre composite, with stainless steel cams and locking nuts, and aluminium alloy bushes. The fixator types comprise standard fixators, fixators with a periarticular ring attachment, and fixators with a swivel clamp for ankles. Between December 2000 and May 2002 the authors tasted the biomechanical effectiveness of the new fixators in 13 patients with leg fractures. After a follow up of 6 months, analysing the results of other centres the authors retook the utilization of the radiolucent fixator and, in this paper, relate their total experience until April 2004 in 42 patients with leg fractures.
Fractures of the distal metaphysis of the tibia represent 7–10% of tibial fractures and less than 1% of the lower limb fractures. Their treatment is difficult and presents a high percentage of bad results because of comminution of the metaphyseal bone fragments, articular involvement, poor circulation in the distal third of the leg. Until few years ago, in presence of a comminuted fracture, the only surgical possibility was the use of plate and screws. The external fixation represented a temporaneous treatment in case of open fracture or severe soft tissue damage. The recent technology applicated to external fixation has transformed the external fixator in synthesis device less uncomfortable, to increase the compliance of the patient, and more stable, to be used in the definitive treatment of this fractures. Recently we change the external fixator with double ring in a monolateral external fixator with single ring, in the “hybrid frame”.
The aim of the study was review all the type B and Type C according with A.O. classification tibial plateau fractures from January 1995 to August 2004 with a minimum follow up of six months. It has been selected all the patients treated with closed surgery. In the treatment of type B fractures we used cannulated screws, sometimes with external fixator. In the treatment of type C fractures we used external fixator. As a result of the technical improvements, in the recent years, external fixation has become a surgical technique not only for the treatment of open fractures but also for the management of comminuted fractures with percutaneous synthesis, since there is no need to open the fracture site. In our recently experience we have used a hybrid fixator which is single-use, pre-assembled and radiolucent.
