PMID- 23271663
OWN - NLM
STAT- MEDLINE
DCOM- 20130507
LR  - 20220408
IS  - 1434-3916 (Electronic)
IS  - 0936-8051 (Linking)
VI  - 133
IP  - 3
DP  - 2013 Mar
TI  - Relationship between distal screws and femoral arteries in closed hip nailing on 
      computed tomography angiography.
PG  - 361-6
LID - 10.1007/s00402-012-1674-5 [doi]
AB  - BACKGROUND: Iatrogenic vascular injury as a result of closed hip nailing is not 
      common, but is a regularly reported complication after hip fracture surgeries. 
      METHODS: To prevent vascular injury in closed hip nailing by identifying the 
      range of distances and angles between deep and superficial femoral arteries (DFAs 
      and SFAs) and distal screws. PATIENTS AND METHODS: Forty subjects who underwent 
      computed tomography angiographies were included in this study. Imaginary lines 
      marking the distal screws (proximal femoral nail antirotation-II [PFNA-II], 180 
      and 300 mm; inter-trochanteric/sub-trochanteric nails [ITST], 200 and 300 mm) 
      were drawn on the scout film. On arterial phase images, angles between distal 
      screw lines and those marking DFAs or SFAs, as well as the distance between each 
      artery and far cortex, were measured using the cross-reference capabilities of 
      the picture archiving and communication system. RESULTS: The short nails (PFNA-II 
      200 mm and ITST 180 mm) were closest to the DFAs, indicating that these nails are 
      most likely to cause injury (PFNA-II 200 mm: 11.2 +/- 13.7 degrees  anterior and 
      9.87 +/- 5.83 mm; ITST 180 mm: 22.56 +/- 15.92 degrees  posterior and 9.24 +/- 4.74 mm). The 
      short nails were relatively distant from the SFAs, which were located posteriorly 
      to the long nails (PFNA-II 300 mm and ITST 300 mm). CONCLUSIONS: These data 
      indicate that insertion of distal screws into intramedullary nails increases the 
      risk of injury to vascular structures. Surgeons must take care in drilling or 
      inserting screws to ensure the prevention of vascular injury.
FAU - Han, Chang Dong
AU  - Han CD
AD  - Department of Orthopaedic Surgery, Yonsei University College of Medicine, 50 
      Yonsei-ro, Seodaemun-gu, Seoul, Korea.
FAU - Lee, Young Han
AU  - Lee YH
FAU - Yang, Kyu Hyun
AU  - Yang KH
FAU - Yang, Ick Hwan
AU  - Yang IH
FAU - Lee, Woo Suk
AU  - Lee WS
FAU - Park, Yoo Jung
AU  - Park YJ
FAU - Suh, Jin Suk
AU  - Suh JS
FAU - Park, Kwan Kyu
AU  - Park KK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121228
PL  - Germany
TA  - Arch Orthop Trauma Surg
JT  - Archives of orthopaedic and trauma surgery
JID - 9011043
SB  - IM
MH  - Aged
MH  - Angiography
MH  - Bone Nails/adverse effects
MH  - Bone Screws/*adverse effects
MH  - Female
MH  - Femoral Artery/*diagnostic imaging/*injuries
MH  - Fracture Fixation, Intramedullary/*adverse effects
MH  - Hip Fractures/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tomography, X-Ray Computed
MH  - Vascular System Injuries/etiology/*prevention & control
EDAT- 2012/12/29 06:00
MHDA- 2013/05/08 06:00
CRDT- 2012/12/29 06:00
PHST- 2012/07/02 00:00 [received]
PHST- 2012/12/29 06:00 [entrez]
PHST- 2012/12/29 06:00 [pubmed]
PHST- 2013/05/08 06:00 [medline]
AID - 10.1007/s00402-012-1674-5 [doi]
PST - ppublish
SO  - Arch Orthop Trauma Surg. 2013 Mar;133(3):361-6. doi: 10.1007/s00402-012-1674-5. 
      Epub 2012 Dec 28.