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Descriptive analysis of incidence and risk factors for short intramedullary nail breakage in femoral intertrochanteric fractures: a multicenter (TRON group) retrospective study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

The incidence of hip fractures is increasing. Femoral intertrochanteric fractures make up 50% of hip fractures and are treated by intramedullary nails. Implant breakage is a recognized complication that can have rare and serious implications. This study aimed to investigate implant breakage rates after surgical treatment for femoral intertrochanteric fractures.

Methods

This was a retrospective multicenter analysis. All 1854 patients who underwent surgical treatment for femoral intertrochanteric fractures were selected from 12 hospitals (TRON group) between 2016 and 2020. Exclusion criteria included implants other than those specified and follow-up periods less than three months. Demographic data, surgical details, and radiographic assessments were collected from medical records and X-ray evaluations.

Results

Among the 983 study patients, consisting of 245 males (24.9%) and 738 females (75.1%), the implant breakage rate was 0.31%, with three confirmed cases. The average age was 83.9 years. The mean follow-up period was 640.9 days. Two cases were linked to ASULOCK implants, and one to an OLSII implant. Statistical analysis showed a significantly higher incidence of ASULOCK implant breakage (p < 0.001). In the two cases of ASULOCK implant breakage and one case of OLSII implant breakage, breakage in all three implants occurred at the anti-rotation screws.

Conclusions

There were no implant breakages of the main body of the implants; all breakages occurred in the additional anti-rotation screw. The necessity of the anti-rotation screw will require further discussion. These results can potentially inform clinical decisions and guide further research in preventing implant breakage.

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Data availability

The datasets collected during and/or analyzed during the current study will be available from the corresponding author on reasonable request.

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Acknowledgment

We thank the Members of the Trauma research of Nagoya group (shown in alphabetical order of affiliation) as follows: Dr. Takeshi Oguchi (Anjo Kosei Hospital), Dr. Keigo Ito (Chubu Rosai Hospital), Dr. Masahiro Hanabayashi (Ichinomiya Municipal Hospital), Dr. Hiroaki Yoshida (Kamiiida Daiichi General Hospital), Dr. Tokumi Kanemura (Konan Kosei Hospital), Dr. Hidenori Inoue (Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital), Dr. Toshihiro Ando (Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital), Dr. Koji Maruyama (Nakatsugawa Municipal General Hospital), Dr. Kenichi Yamauchi (Toyohashi Municipal Hospital), Dr. Yasuhide Kanayama (Toyota Kosei Hospital), Dr. Tadahiro Sakai (TOYOTA Memorial Hospital), and Dr. Nobuhiro Okui (Yokkaichi Municipal Hospital).

Funding

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan

    Hirokazu Noritake, Yasuhiko Takegami, Hiroaki Nakashima, Kenichi Mishima & Shiro Imagama

  2. Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Katsuhiro Tokutake

  3. Department of Orthopaedic Surgery, Tsushima City Hospital, Tsushima, Japan

    Takanori Ito

Authors
  1. Hirokazu Noritake
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  2. Yasuhiko Takegami
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  4. Hiroaki Nakashima
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  5. Kenichi Mishima
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  6. Takanori Ito
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  7. Shiro Imagama
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Contributions

HN participated in data collection and assessment, study design, and writing the paper. YT was involved in manuscript preparation, study, and conception design. KT was involved in manuscript preparation, study design, and revision. HN and KM revised manuscript preparation. TI hepled with resources and data collection. SI helped with conception design and is the guarantor.

Corresponding author

Correspondence to Yasuhiko Takegami.

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This research has been approved by the IRB of the authors’ affiliated institutions. The approval number in our institute is 2020-0564.

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Noritake, H., Takegami, Y., Tokutake, K. et al. Descriptive analysis of incidence and risk factors for short intramedullary nail breakage in femoral intertrochanteric fractures: a multicenter (TRON group) retrospective study. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03957-z

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  • DOI: https://doi.org/10.1007/s00590-024-03957-z

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