{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:53:49Z","timestamp":1790913229019,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Depth\u2010gauge measurements can be time\u2010consuming and prone to technical error. The aim of this study is to evaluate whether \u201canatomic zones\u201d along the distal femur can be used to help estimate distal interlocking screw length during femoral intramedullary nailing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective \u201canatomical control\u201d cohort was used to establish anatomic zones along the length of the distal femur and estimated screw length within each zone. Estimated screw lengths for each zone were based on mean cortex\u2010to\u2010cortex length at each zone as measured on computed tomography (CT). A validation cohort was prospectively enrolled to evaluate agreement between these estimated screw lengths and depth\u2010gauge measurements for each zone. Agreement was evaluated using mean differences between estimated screw lengths and depth\u2010gauge measurements, an intraclass correlation coefficient (ICC), and Bland\u2013Altman analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The retrospective cohort of 56 patients was used to establish eight anatomic zones. Screw length estimates derived from CT\u2010based measurements ranged between 42.1\u2009mm in the most proximal zone to 80.2\u2009mm in the most distal zone. The validation cohort included 74 patients (126 screws), was 63.51% male (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200947), with mean age 44.2\u2009\u00b1\u200924.7\u2009years, mean height 173.2\u2009\u00b1\u200912.7\u2009cm, and mean BMI 28.5\u2009\u00b1\u200910\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . The mean absolute value difference between zone\u2010estimated screw lengths and depth\u2010gauge measurements was 3.9\u2009mm \u00b12.9\u2009mm, ranging 2.7\u2009mm\u20105.6\u2009mm depending on zone. The ICC was 0.94 (95% CI [0.91, 0.96],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Bland\u2013Altman analysis revealed a bias of \u22120.86\u2009mm with limits of agreement at +8.6\u2009mm and \u221210.3\u2009mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anatomic zone\u2010based screw length estimates derived from CT data show strong agreement with depth\u2010gauge measurements and are a potential adjunctive strategy to reduce operative time and errors in screw length selection without the need for additional equipment or technology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70401","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:35:16Z","timestamp":1787146516000},"page":"2176-2182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distal Femoral Interlocking Screw Length Can be Estimated Using \u201cAnatomic Zones\u201d During Femoral Intramedullary Nailing"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2600-7855","authenticated-orcid":false,"given":"Douglas","family":"Zhang","sequence":"first","affiliation":[{"name":"Pritzker School of Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden P.","family":"Baker","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6506-8423","authenticated-orcid":false,"given":"Mary Kate","family":"Erdman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1533-8114","authenticated-orcid":false,"given":"Anthony V.","family":"Christiano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-1595","authenticated-orcid":false,"given":"Jason","family":"Strelzow","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Washington University School of Medicine  Saint Louis Missouri 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