Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications
Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, whi...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Pires, Robinson Esteves Santos [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Anmerkung: |
© Pires et al; licensee BioMed Central Ltd. 2011 |
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| Übergeordnetes Werk: |
Enthalten in: Patient safety in surgery - London : BioMed Central, 2007, 5(2011), 1 vom: 22. Juni |
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| Übergeordnetes Werk: |
volume:5 ; year:2011 ; number:1 ; day:22 ; month:06 |
| Links: |
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| DOI / URN: |
10.1186/1754-9493-5-17 |
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SPR02957174X |
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| 520 | |a Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. | ||
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| 700 | 1 | |a dos Reis, Fernando Baldy |4 aut | |
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10.1186/1754-9493-5-17 doi (DE-627)SPR02957174X (SPR)1754-9493-5-17-e DE-627 ger DE-627 rakwb eng Pires, Robinson Esteves Santos verfasserin aut Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pires et al; licensee BioMed Central Ltd. 2011 Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 Santana, Egídio Oliveira aut Santos, Leandro Emílio Nascimento aut Giordano, Vincenzo aut Balbachevsky, Daniel aut dos Reis, Fernando Baldy aut Enthalten in Patient safety in surgery London : BioMed Central, 2007 5(2011), 1 vom: 22. Juni (DE-627)558389643 (DE-600)2409244-7 1754-9493 nnns volume:5 year:2011 number:1 day:22 month:06 https://dx.doi.org/10.1186/1754-9493-5-17 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2011 1 22 06 |
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10.1186/1754-9493-5-17 doi (DE-627)SPR02957174X (SPR)1754-9493-5-17-e DE-627 ger DE-627 rakwb eng Pires, Robinson Esteves Santos verfasserin aut Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pires et al; licensee BioMed Central Ltd. 2011 Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 Santana, Egídio Oliveira aut Santos, Leandro Emílio Nascimento aut Giordano, Vincenzo aut Balbachevsky, Daniel aut dos Reis, Fernando Baldy aut Enthalten in Patient safety in surgery London : BioMed Central, 2007 5(2011), 1 vom: 22. Juni (DE-627)558389643 (DE-600)2409244-7 1754-9493 nnns volume:5 year:2011 number:1 day:22 month:06 https://dx.doi.org/10.1186/1754-9493-5-17 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2011 1 22 06 |
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10.1186/1754-9493-5-17 doi (DE-627)SPR02957174X (SPR)1754-9493-5-17-e DE-627 ger DE-627 rakwb eng Pires, Robinson Esteves Santos verfasserin aut Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pires et al; licensee BioMed Central Ltd. 2011 Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 Santana, Egídio Oliveira aut Santos, Leandro Emílio Nascimento aut Giordano, Vincenzo aut Balbachevsky, Daniel aut dos Reis, Fernando Baldy aut Enthalten in Patient safety in surgery London : BioMed Central, 2007 5(2011), 1 vom: 22. Juni (DE-627)558389643 (DE-600)2409244-7 1754-9493 nnns volume:5 year:2011 number:1 day:22 month:06 https://dx.doi.org/10.1186/1754-9493-5-17 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2011 1 22 06 |
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10.1186/1754-9493-5-17 doi (DE-627)SPR02957174X (SPR)1754-9493-5-17-e DE-627 ger DE-627 rakwb eng Pires, Robinson Esteves Santos verfasserin aut Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pires et al; licensee BioMed Central Ltd. 2011 Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 Santana, Egídio Oliveira aut Santos, Leandro Emílio Nascimento aut Giordano, Vincenzo aut Balbachevsky, Daniel aut dos Reis, Fernando Baldy aut Enthalten in Patient safety in surgery London : BioMed Central, 2007 5(2011), 1 vom: 22. Juni (DE-627)558389643 (DE-600)2409244-7 1754-9493 nnns volume:5 year:2011 number:1 day:22 month:06 https://dx.doi.org/10.1186/1754-9493-5-17 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2011 1 22 06 |
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10.1186/1754-9493-5-17 doi (DE-627)SPR02957174X (SPR)1754-9493-5-17-e DE-627 ger DE-627 rakwb eng Pires, Robinson Esteves Santos verfasserin aut Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pires et al; licensee BioMed Central Ltd. 2011 Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 Santana, Egídio Oliveira aut Santos, Leandro Emílio Nascimento aut Giordano, Vincenzo aut Balbachevsky, Daniel aut dos Reis, Fernando Baldy aut Enthalten in Patient safety in surgery London : BioMed Central, 2007 5(2011), 1 vom: 22. Juni (DE-627)558389643 (DE-600)2409244-7 1754-9493 nnns volume:5 year:2011 number:1 day:22 month:06 https://dx.doi.org/10.1186/1754-9493-5-17 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2011 1 22 06 |
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Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications Femoral Head (dpeaa)DE-He213 Intertrochanteric Fracture (dpeaa)DE-He213 Proximal Femoral Fracture (dpeaa)DE-He213 Subtrochanteric Fracture (dpeaa)DE-He213 Poor Bone Quality (dpeaa)DE-He213 |
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failure of fixation of trochanteric femur fractures: clinical recommendations for avoiding z-effect and reverse z-effect type complications |
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Failure of fixation of trochanteric femur fractures: Clinical recommendations for avoiding Z-effect and reverse Z-effect type complications |
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Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. © Pires et al; licensee BioMed Central Ltd. 2011 |
| abstractGer |
Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. © Pires et al; licensee BioMed Central Ltd. 2011 |
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Background Z-effect and reverse Z-effect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails (PFN) comprising two interlocking head screws. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. The occurrence of Z-effect and reverse Z-effect has not been completely elucidated, but the main causes of such complications are probably fracture fixation in varus position, severe medial comminution, inappropriate entry point of the nail and poor bone quality. © Pires et al; licensee BioMed Central Ltd. 2011 |
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Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. Findings The paper describes three cases of pertrochanteric fractures that were treated with PFN with two interlocking screws that evolved to either Z-effect or reverse Z-effect. Literature-based explanations for this phenomenon are provided together with recommendations of how to avoid such complications. Conclusions Although intramedullary fixation is an established method of treatment of femoral intertrochanteric and subtrochanteric fractures, the evolution of the procedure may include complications associated with the migration of the interlocking head screws. 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