Abstract
Introduction The fractures that occurred around trochanteric nails (perinail fractures, PNFs) are becoming a huge challenge for the orthopaedic surgeon. Although presenting some specific critical issues (i.e., patients' outcomes and treatment strategies), these fractures are commonly described within peri-implant ones and their treatment was based on periprosthetic fracture recommendations. The knowledge gap about PNFs leads us to convene a research group with the aim to propose a specific classification system to guide the orthopaedic surgeon in the management of these fractures. Materials and Methods A steering committee, identified by two Italian associations of orthopaedic surgeons, conducted a comprehensive literature review on PNFs to identify the unmet needs about this topic. Subsequently, a panel of experts was involved in a consensus meeting proposing a specific classification system and formulated treatment statements for PNFs. Results and Discussion. The research group considered four PNF main characteristics for the classification proposal: (1) fracture localization, (2) fracture morphology, (3) fracture fragmentation, and (3) healing status of the previous fracture. An alphanumeric code was included to identify each characteristic, allowing to describe up to 54 categories of PNFs, using a 3- to 4-digit code. The proposal of the consensus-based classification reporting the most relevant aspects for PNF treatment might be a useful tool to guide the orthopaedic surgeon in the appropriate management of these fractures.
Highlights
Fractures around nails are a huge challenge for the orthopaedic surgeon with a constantly rising incidence due to the increased frequency of hip fragility fractures worldwide [1, 2]. ese fractures are commonly classified into two groups “intracapsular” and “extracapsular” (EF)
E research group included four perinail fractures (PNFs) characteristics considered relevant for their treatment in the classification proposal in the following hierarchical order: (1) Fracture localization (around the nail, around the distal screw, and distal from the tip of the nail), consensus 98%
Fracture localization, fracture morphology, fracture fragmentation, and healing status of the previous EF were the most relevant factors for the management of PNFs. e fracture localization was considered relevant because fixation devices are anatomically shaped and the choice of a specific fixation device depends on the relationship of the fracture line with the implanted trochanteric nails (TNs)
Summary
Fractures around nails are a huge challenge for the orthopaedic surgeon with a constantly rising incidence due to the increased frequency of hip fragility fractures worldwide [1, 2]. ese fractures are commonly classified into two groups “intracapsular” and “extracapsular” (EF). E research group included four PNF characteristics considered relevant for their treatment in the classification proposal in the following hierarchical order: (1) Fracture localization (around the nail (namely, from the cephalic to the distal screw), around the distal screw, and distal from the tip of the nail), consensus 98%
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
