{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T10:44:48Z","timestamp":1747651488127,"version":"3.37.3"},"reference-count":23,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2024,1,27]]},"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>: Lateral fractures of proximal femur are the most frequent fractures in elderly people. Internal fixation using medullary nails is the gold standard of treatment (Gamma 3 nail is the most implanted device) due to reduced incidence of complications than other devices. We report our experience in treating this kind of fractures with Gamma 3 nail, between January 2015 and December 2021. <jats:italic>Methods<\/jats:italic>: We performed a retrospective cohort study of patients treated in our orthopaedic department; level of clinical care is III: 559 patients (431 females and 128 males, with an average age of 85.3\u00a0years) with lateral femoral neck fracture. All patients were surgically treated with Gamma 3 standard nail (SGN). We evaluated preliminary X-rays to classify fractures, according to AO-OTA classification and post-operative X-ray to verify cephalic screw position site, according to areas described by Cleveland in 1959: we measured tip-to-apex distance (TAD) and tip-to-apex calcar referred distance (CalTAD). Finally Chang reduction quality criteria (CRQC) for fracture reduction of trochanteric fractures were determined using preoperative or postoperative Antero-Posterior (AP) and lateral radiographs in a Picture Archiving and Communication System (PACS). Incidence of cut-out was evaluated in relation with these parameters. Patients were divided into 2 groups: first group had cephalic screw in optimal positions (5-8-9), the other group had cephalic screw in other positions. <jats:italic>Results<\/jats:italic>: In 328 patients (58.7%) screw was in positions 5-8-9, in 231 patients (41.2%) screw was in not-optimal position. Median TAD was 19.1\u00a0\u00b1\u00a07.0\u00a0mm (range\u00a0=\u00a00.0\u201350.5); in 463 patients (82.8%) TAD was\u00a0\u2264\u00a025\u00a0mm. Median CalTAD was 21.4\u00a0\u00b1\u00a04.7\u00a0mm (range\u00a0=\u00a05.7\u201339.2); in 105 patients (79.4%) CalTAD was\u00a0\u2264\u00a025\u00a0mm. Cut-out was observed in 8 cases (1.43%). Multivariate analysis showed a significant correlation (p\u00a0&lt;\u00a00,05) between incidence of cut-out and fracture type 31A2 and with TAD values\u00a0&gt;25\u00a0mm. Cephalic screw position did not influence incidence of cut-out. <jats:italic>Discussion<\/jats:italic>: In order to obtain fracture healing with a low risk of failure, in particular cut-out, it is necessary to obtain good reduction of fracture and optimal lag screw position in order to achieve a TAD inferior to 25\u00a0mm.<\/jats:p>","DOI":"10.1051\/sicotj\/2024006","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T09:02:16Z","timestamp":1709110936000},"page":"9","source":"Crossref","is-referenced-by-count":3,"title":["Correlation between cephalic screw positioning of Standard Gamma 3 Nail for intertrochanteric fractures and cut-out incidence"],"prefix":"10.1051","volume":"10","author":[{"given":"Alessandro","family":"Ortolani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-184X","authenticated-orcid":false,"given":"Debora","family":"Lana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Martucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Pesce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Stallone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Milani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Urso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Melucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Tigani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"250","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12306-015-0391-y","volume":"100","author":"Pascarella","year":"2016","journal-title":"Musculoskelet Surg"},{"issue":"1","key":"R2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/1471-2474-11-133","volume":"11","author":"Bojan","year":"2010","journal-title":"BMC Musculoskelet Disord"},{"issue":"8","key":"R3","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.2106\/00004623-195941080-00003","volume":"41","author":"Cleveland","year":"1959","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"R4","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00402-015-2206-x","volume":"135","author":"Chang","year":"2015","journal-title":"Arch Orthop Trauma Surg"},{"key":"R5","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/j.injury.2003.10.028","volume":"35","author":"Pervez","year":"2004","journal-title":"Injury"},{"key":"R6","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/0020-1383(89)90151-4","volume":"20","author":"Mainds","year":"1989","journal-title":"Injury"},{"key":"R7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/0020-1383(91)90161-7","volume":"22","author":"Thomas","year":"1991","journal-title":"Injury"},{"key":"R8","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/BOT.0b013e318229acca","volume":"26","author":"Kuzyk","year":"2012","journal-title":"J Orthop Trauma"},{"key":"R9","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1002\/jor.22266","volume":"31","author":"Goffin","year":"2013","journal-title":"J Orthop Res"},{"issue":"8","key":"R10","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1302\/0301-620X.96B8.33644","volume":"96","author":"Kashigar","year":"2014","journal-title":"Bone Joint J"},{"key":"R11","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.2106\/00004623-199507000-00012","volume":"77-A","author":"Baumgaertner","year":"1995","journal-title":"J Bone Joint Surg [Am]"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Taglang G (2006) Practice of Intramedullary Locked Nails 2006. 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