Re-understanding the value of the tip-apex distance theory in guiding treatment of intertrochanteric femoral fracture
10.3760/cma.j.cn501098-20221121-00768
- VernacularTitle:重新认识尖顶距学说指导股骨转子间骨折治疗的价值
- Author:
Dianying ZHANG
1
Author Information
1. 北京大学人民医院创伤骨科，国家创伤医学中心，创伤救治与神经再生教育部重点实验室，北京 100044
- Keywords:
Femoral fractures;
Postoperative complications;
Tip-apex distance
- From:
Chinese Journal of Trauma
2023;39(2):121-126
- CountryChina
- Language:Chinese
-
Abstract:
Intertrochanteric femoral fracture occurs frequently in elderly osteoporotic patients, with high disability and mortality, for which surgical treatment is necessary. Common surgical modalities for intertrochanteric femoral fracture include intramedullary and extramedullary internal fixation systems, but neither can avoid the complications like internal fixation cut-out or internal fixation cut-through of the femoral head after surgery. The tip-apex distance theory was once considered to be of great significance in avoiding internal fixation cut-out, with the mainstream view was that screw cut-out could be avoided to the maximum extent when the tip-apex distance was ≤25 mm. However, internal fixation that meets the criteria of the tip-apex distance theory may also show cut-out and "Z-effect" in clinical practice, which lacks a reasonable explanation. Based on the lever balance reconstruction theory and the buttress-stretch effect, the author re-understands the value of the tip-apex distance theory in guiding treatment of intertrochanteric femoral fracture, hoping to propose an enlightenment for the treatment of intertrochanteric femoral fracture.
