{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:27:44Z","timestamp":1788434864940,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"\n Objectives:<\/jats:title>\n To determine whether fixation of pertrochanteric hip fractures with cephalomedullary nails (CMNs) with a neck-shaft angle (NSA) less than the native NSA affects reduction and lag screw cutout.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective comparative study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Level I trauma center.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants:<\/jats:title>\n Patients treated with a CMN for unstable pertrochanteric femur fractures (OTA\/AO 31-A2.2 and 31-A2.3) between 2005 and 2014.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n CMN fixation.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurement:<\/jats:title>\n NSA reduction and lag screw cutout.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Patients fixed with a nail angle less than their native NSA were less likely to have good reductions [17% vs. 60%, 95% confidence interval (CI), \u221263% to \u221218%;\n P<\/jats:italic>\n = 0.0005], secondary to more varus reductions (41% vs. 10%, 95% CI, 9%\u201346%;\n P<\/jats:italic>\n = 0.01) and more fractures with \u22654 mm of displacement (63% vs. 35%, 95% CI, 3%\u201349%;\n P<\/jats:italic>\n = 0.03). The cutout was not associated with the use of a nail angle less than the native NSA (60% vs. 76%, 95% CI, \u221256% to 18%;\n P<\/jats:italic>\n = 0.5), varus reductions (60% vs. 32%, 95% CI, \u221213% to 62%;\n P<\/jats:italic>\n = 0.3), or poor reductions (20% vs. 17%, 95% CI, \u221224% to 44%;\n P<\/jats:italic>\n = 1.0).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The fixation of unstable pertrochanteric hip fractures with a nail angle less than the native NSA was associated with more varus reductions and fracture displacement but did not affect the lag screw cutout.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000001096","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T09:54:58Z","timestamp":1516960498000},"page":"174-177","source":"Crossref","is-referenced-by-count":26,"title":["Does the Angle of the Nail Matter for Pertrochanteric Fracture Reduction? Matching Nail Angle and Native Neck-Shaft Angle"],"prefix":"10.1097","volume":"32","author":[{"given":"Joshua A.","family":"Parry","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Barrett","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Schoch","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Florida, Gainesville, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Cass","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Cross","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"18195","DOI":"10.1038\/srep18195","article-title":"Internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence","volume":"5","author":"Yu","year":"2015","journal-title":"Scientific Rep."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00264-013-2196-7","article-title":"Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur","volume":"38","author":"Aktselis","year":"2014","journal-title":"Int Orthop."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2474-14-1","article-title":"Critical factors in cut-out complication after Gamma Nail treatment of proximal femoral fractures","volume":"14","author":"Bojan","year":"2013","journal-title":"BMC Musculoskelet Disord."},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.2106\/00004623-199507000-00012","article-title":"The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip","volume":"77","author":"Baumgaertner","year":"1995","journal-title":"J Bone Joint Surg Am."},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1302\/0301-620X.74B4.1624529","article-title":"Cutting-out of the dynamic hip screw related to its position","volume":"74","author":"Parker","year":"1992","journal-title":"J Bone Joint Surg Br."},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1007\/s00264-012-1636-0","article-title":"Tip apex distance, hip screw placement, and neck shaft angle as potential risk factors for cut-out failure of hip screws after surgical treatment of intertrochanteric fractures","volume":"36","author":"Andruszkow","year":"2012","journal-title":"Int Orthop."},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/0020-1383(93)90053-9","article-title":"Valgus reduction of trochanteric fractures","volume":"24","author":"Parker","year":"1993","journal-title":"Injury."},{"key":"R8-20230828","first-page":"347","article-title":"Femoral shaft medialisation and neck-shaft angle in unstable pertrochanteric femoral fractures","volume":"28","author":"Pajarinen","year":"2004","journal-title":"Int Orthopaedics."},{"key":"R9-20230828","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.injury.2005.06.039","article-title":"Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; 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