Is Tip Apex Distance As Important As We Think? A Biomechanical Study Examining Optimal Lag Screw Placement

摘要

BackgroundIntertrochanteric hip fractures pose a significant challenge for the orthopaedic community as optimal surgical treatment continues to be debated. Currently, varus collapse with lag screw cutout is the most common mode of failure. Multiple factors contribute to cutout. From a surgical technique perspective, a tip apex distance less than 25 mm has been suggested to decrease the risk of cutout. We hypothesized that a low-center lag screw position in the femoral head, with a tip apex distance greater than 25 mm will provide equal, if not superior, biomechanical stability compared with a center-center position with a tip apex distance less than 25 mm in an unstable intertrochanteric hip fracture stabilized with a long cephalomedullary nail.