Three-dimensional correlation between trochanteric fossa and the ideal entry point for antegrade femoral nailing.

Purpose: To verify the practical correlation between the topographical features of the femur neck base and the ideal entry point by analyzing three-dimensional (3D) models virtually implanted with an antegrade femoral nail.Materials and Methods: A total of 103 cadaveric femurs (50 males and 53 femal...

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Publicado en:Injury Vol. 47; no. 11; pp. 2539 - 2544
Autores principales: Byun, Young-Soo, Jung, Gu-Hee
Formato: Journal Article
Publicado: Elsevier B.V. Nov2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2016
      vid: 47
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      pub: Elsevier B.V.
      place: New York, New York
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        119176948
        119176948
        NLM27665226
        10.1016/j.injury.2016.09.026
        NLM27665226
        119176948
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        atl: Three-dimensional correlation between trochanteric fossa and the ideal entry point for antegrade femoral nailing.
      aug:
        au:
          Byun, Young-Soo
          Jung, Gu-Hee
        affil: Department of Orthopaedic Surgery, Fatima Hospital, 99 Ayang-ro, Dong-gu, Dae-gu, Republic of Korea
      sug:
        subj:
          Fracture Fixation
          Femur Anatomy and Histology
          Imaging, Three-Dimensional
          Image Processing, Computer Assisted
          Fracture Fixation Methods
          Models, Biological
          Cadaver
          Software
          Young Adult
          Orthopedic Fixation Devices
          Prostheses and Implants Methods
          Tomography, X-Ray Computed
          Adult
          Middle Age
          Male
          Female
          South Korea
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: To verify the practical correlation between the topographical features of the femur neck base and the ideal entry point by analyzing three-dimensional (3D) models virtually implanted with an antegrade femoral nail.Materials and Methods: A total of 103 cadaveric femurs (50 males and 53 females) were enrolled. Specimens underwent continuous 1.0mm slice computed tomography (CT) scans. CT images were rendered into 3D images using image-processing software (Mimics®) to reconstruct the geometry of the cortex and medullary canal. A real cannulated femoral nail (CFN)® was processed into a 3D image using a 3D sensor at the actual size and optimally placed in the femur model using Mimics® for virtual implantation. The correlation between the ideal entry point in the cranial view of the proximal femur and the trochanteric fossa was assessed and overlap of trochanter overhang was verified.Results: The entry point of 68 models (66.0%) was the trochanteric fossa, while the others were placed around the anterior border of the trochanteric fossa. The proximal end of the nail overlapped in 50 models (48.1%), and among them, the central point of 23 models (22.3%) was obscured by trochanteric overhang. There was a statistically significant risk associated with female gender (6.02 times) and type IV overhang of Grenchenig's classification (4.56 times). Despite the precise positioning of the trochanteric fossa, 11 models (10.7%) had the entry point covered by trochanteric overhang.Conclusion: The ideal entry point was over the trochanteric fossa in just half of the models, and could be hindered by trochanteric overhang even though the CFN was ideally positioned.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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