Análise do emprego do parafuso antirrotacional nos dispositivos cefalomedulares nas fraturas do fêmur proximal

Abstract

Objectiveto analyze the influence of femoral neck diameter in the positioning of the sliding screw in cefalomedulares nails for treatment of unstable transtrochanteric fractures. Methodsprospectively throughout 2011, patients with unstable fractures transtrochanteric undergoing osteosynthesis with cephalomedullary nail using antirotacional device. Were evaluated for sex, age and fracture classification according to Tronzo. Through digital radiographs were measured angle reduction, tip apex distance (TAD), stem diameter and measures between the positioning of the screws and the limits of the cervix. Resultsof 58 patients, 42 (72.4%) were female and 16 (27.6%) were male. Thirty threepatients were classified as Tronzo III (56.9%), 6 patients as Tronzo IV (10.4%) and 19V as Tronzo (19.8%). The majority had between the eighth and ninth decade of life. The average reduction in the angle of females was 130.05° and 129.4° for males. The TAD average was 19.7mm for females and 21.6 for males. The average diameter of the neck and head vary with statistical significance between men and women. In 19 patients the placement of the sliding bolt can be optimally. If the ideal positioning was not possible, the mean displacement for non-infringement of higher cortical neck was 4.06mm. Conclusionthe optimal placement would not be possible for the majority of the population, for the average diameter of the neck of the sample.