Cargando…

Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction

BACKGROUND: The lesser trochanter (LT) posterior cortical extension (LTPE) fragment is important for joint stability during reconstruction in unstable pertrochanteric hip fractures. This study aimed to investigate the morphological characteristics of the LT fragments using three-dimensional computed...

Descripción completa

Detalles Bibliográficos
Autores principales: Xiong, Wen-Feng, Zhang, Ying-Qi, Chang, Shi-Min, Hu, Sun-Jun, Du, Shou-Chao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436204/
https://www.ncbi.nlm.nih.gov/pubmed/30889172
http://dx.doi.org/10.12659/MSM.913593
_version_ 1783406768143990784
author Xiong, Wen-Feng
Zhang, Ying-Qi
Chang, Shi-Min
Hu, Sun-Jun
Du, Shou-Chao
author_facet Xiong, Wen-Feng
Zhang, Ying-Qi
Chang, Shi-Min
Hu, Sun-Jun
Du, Shou-Chao
author_sort Xiong, Wen-Feng
collection PubMed
description BACKGROUND: The lesser trochanter (LT) posterior cortical extension (LTPE) fragment is important for joint stability during reconstruction in unstable pertrochanteric hip fractures. This study aimed to investigate the morphological characteristics of the LT fragments using three-dimensional computed tomography (3-D CT) reconstruction and to compare clinical outcomes in different subgroups of 31A2 fractures. MATERIAL/METHODS: A retrospective study included CT images of 58 cases of 31A2 type unstable pertrochanteric fractures, using the Arbeitsgemeinschaft für Osteosynthesefragen and Orthopedic Trauma Association (AO/OTA) classification. After 3-D CT reconstruction, all the displaced fragments were reduced and the morphologic parameters of the LT fragments were measured. RESULTS: At the mid-level of the LT, the mean cortical extension of the LT fragment was 33.5 mm in the posterior wall (83%), 19.0 mm in the medial wall (53%). The mean distal cortical extension from the lower edge of the LT was 13.0 mm. The LT fragment occupied 38% of the whole cortical circumference. Comparison of the subgroups showed that the LT fragment of A2.3 had a larger cortical extension in the posterior, medial, and distal cortex. The mean fracture collapse was 4.7 mm in A2.2 fractures and 5.4 mm in A2.3 fractures (p=0.311). Despite the increased size of the LT fragment in subtype A2.3 fracture compared with subtype A2.2 fracture, this did not influence the clinical outcome. CONCLUSIONS: The 3-D morphology of the LT fragment from CT imaging provided a better understanding of the characteristics of subgroups of unstable pertrochanteric fractures, which may improve and guide implant choice.
format Online
Article
Text
id pubmed-6436204
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher International Scientific Literature, Inc.
record_format MEDLINE/PubMed
spelling pubmed-64362042019-04-17 Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction Xiong, Wen-Feng Zhang, Ying-Qi Chang, Shi-Min Hu, Sun-Jun Du, Shou-Chao Med Sci Monit Clinical Research BACKGROUND: The lesser trochanter (LT) posterior cortical extension (LTPE) fragment is important for joint stability during reconstruction in unstable pertrochanteric hip fractures. This study aimed to investigate the morphological characteristics of the LT fragments using three-dimensional computed tomography (3-D CT) reconstruction and to compare clinical outcomes in different subgroups of 31A2 fractures. MATERIAL/METHODS: A retrospective study included CT images of 58 cases of 31A2 type unstable pertrochanteric fractures, using the Arbeitsgemeinschaft für Osteosynthesefragen and Orthopedic Trauma Association (AO/OTA) classification. After 3-D CT reconstruction, all the displaced fragments were reduced and the morphologic parameters of the LT fragments were measured. RESULTS: At the mid-level of the LT, the mean cortical extension of the LT fragment was 33.5 mm in the posterior wall (83%), 19.0 mm in the medial wall (53%). The mean distal cortical extension from the lower edge of the LT was 13.0 mm. The LT fragment occupied 38% of the whole cortical circumference. Comparison of the subgroups showed that the LT fragment of A2.3 had a larger cortical extension in the posterior, medial, and distal cortex. The mean fracture collapse was 4.7 mm in A2.2 fractures and 5.4 mm in A2.3 fractures (p=0.311). Despite the increased size of the LT fragment in subtype A2.3 fracture compared with subtype A2.2 fracture, this did not influence the clinical outcome. CONCLUSIONS: The 3-D morphology of the LT fragment from CT imaging provided a better understanding of the characteristics of subgroups of unstable pertrochanteric fractures, which may improve and guide implant choice. International Scientific Literature, Inc. 2019-03-19 /pmc/articles/PMC6436204/ /pubmed/30889172 http://dx.doi.org/10.12659/MSM.913593 Text en © Med Sci Monit, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Xiong, Wen-Feng
Zhang, Ying-Qi
Chang, Shi-Min
Hu, Sun-Jun
Du, Shou-Chao
Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title_full Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title_fullStr Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title_full_unstemmed Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title_short Lesser Trochanteric Fragments in Unstable Pertrochanteric Hip Fractures: A Morphological Study Using Three-Dimensional Computed Tomography (3-D CT) Reconstruction
title_sort lesser trochanteric fragments in unstable pertrochanteric hip fractures: a morphological study using three-dimensional computed tomography (3-d ct) reconstruction
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436204/
https://www.ncbi.nlm.nih.gov/pubmed/30889172
http://dx.doi.org/10.12659/MSM.913593
work_keys_str_mv AT xiongwenfeng lessertrochantericfragmentsinunstablepertrochanterichipfracturesamorphologicalstudyusingthreedimensionalcomputedtomography3dctreconstruction
AT zhangyingqi lessertrochantericfragmentsinunstablepertrochanterichipfracturesamorphologicalstudyusingthreedimensionalcomputedtomography3dctreconstruction
AT changshimin lessertrochantericfragmentsinunstablepertrochanterichipfracturesamorphologicalstudyusingthreedimensionalcomputedtomography3dctreconstruction
AT husunjun lessertrochantericfragmentsinunstablepertrochanterichipfracturesamorphologicalstudyusingthreedimensionalcomputedtomography3dctreconstruction
AT dushouchao lessertrochantericfragmentsinunstablepertrochanterichipfracturesamorphologicalstudyusingthreedimensionalcomputedtomography3dctreconstruction