Al Hussainy Haydar A, Martins Andre, Le Giang
Trauma and Orthopaedics, Northampton General Hospital, Northampton, GBR.
Cureus. 2025 Mar 31;17(3):e81508. doi: 10.7759/cureus.81508. eCollection 2025 Mar.
Cephalomedullary nailing systems, including the Trochanteric Femoral Nailing-ADVANCED™ (TFNA) (DePuy Synthes, Raynham, Massachusetts, United States), are widely utilised for stabilising proximal femoral fractures. A pivotal aspect of the procedure involves ensuring adequate tip-apex distance (TAD) of the lag screw below 25 mm, a measure that substantially diminishes the cutout rate. We introduce a simple method to accurately estimate the intraoperative TAD in TFNA fixation. This technique relies on the known diameter of the shaft of the screw (the root diameter), just proximal to the threaded section. The new technique is simple, easy, and effective in potentially reducing operative time and improving the accuracy of estimating TAD during cephalomedullary hip fracture stabilisation surgery.
髓内钉系统，包括股骨近端防旋髓内钉-进阶版（TFNA）（美国马萨诸塞州雷纳姆市的德普伊辛迪思公司），被广泛用于稳定股骨近端骨折。该手术的一个关键方面是确保拉力螺钉的尖顶距（TAD）低于25毫米，这一措施可大幅降低螺钉切出率。我们介绍一种简单方法，可在TFNA固定术中准确估算术中TAD。该技术依赖于紧邻螺纹部分近端的螺钉杆部已知直径（牙根直径）。这项新技术简单、易行，且在潜在地减少手术时间以及提高髋部骨折髓内固定手术中TAD估算准确性方面有效。
