A novel lower bound for tip-apex distance.
Purpose: The cut-out of the cephalomedullary nail is among the most common post-surgery complications for intertrochanteric fractures. As a risk predictor, a tip-apex distance (TAD) below 25 mm, observed from orthogonal fluoroscopic views, is recommended in the literature. This study aims to demonst...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 3; pp. 1787 - 1799 |
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| Autores principales: | , , , , |
| Formato: | equations & formulas pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157411425&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157411425 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Jun2022 vid: 48 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 157411425 146358246 157411425 157411425 10.1007/s00068-020-01514-x 157411425 ppf: 1787 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A novel lower bound for tip-apex distance. aug: au: Subasi, Omer Aslan, Lercan Demirhan, Mehmet Seyahi, Aksel Lazoglu, Ismail affil: Manufacturing and Automation Research Center, Koc University, 34450, Istanbul, Turkey sug: subj: Femoral Fractures Surgery Fracture Fixation Bone Screws Orthopedic Fixation Devices Human Female Male Fluoroscopy Mathematics Software Safety Data Analysis, Statistical Descriptive Statistics Female Male ab: Purpose: The cut-out of the cephalomedullary nail is among the most common post-surgery complications for intertrochanteric fractures. As a risk predictor, a tip-apex distance (TAD) below 25 mm, observed from orthogonal fluoroscopic views, is recommended in the literature. This study aims to demonstrate that TAD < 25 mm is a mathematically insufficient risk definition and to complement the TAD upper bound with an appropriate lower bound, with the introduction of a novel distance parameter, TADX, based on the orthogonal projection of the nail tip on the central femoral midline. Method: Through a mathematical simulation software, all the possible points that lie inside the AP and lateral views of the proximal femoral hemisphere are utilized to create a 3D grid that is sorted into geometrically safe and risk-bearing regions. Extending this methodology, TAD < 25 mm, 10 mm < TAD < 25 mm, and the ideal tip position volumes are simulated. Finally, intersection volumes are created by a combination of different candidate lower TADX bounds and TAD < 25 mm upper bound to determine satisfactory TADX limits. Results: Simulation of TAD-bound zones exposed that TAD is only a mathematically suitable parameter for defining the upper boundary but not the lower boundary for the optimal region. However, using a TADX lower limit creates a 3D volume that is much closer to the optimal tip region volumetrically and can still be as quickly calculated from 2D AP and lateral views. Conclusions: According to the mathematical simulations, the use of a TADX lower bound of 9 mm for small, 7.5 mm for medium, and 7 mm for large femoral heads in conjunction with a TAD upper bound of 25 mm is suggested. pubtype: Academic Journal doctype: equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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