{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:44:25Z","timestamp":1773787465384,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The best intramedullary nail for the treatment of unstable AO\/OTA 31.A2.1-3 fractures remains uncertain. A total of 237 patients (45 male, 192 female) were eligible for the assessment with an average age of 81.9 \u00b1 10.5 years and a minimum follow-up of six months. We assessed the cut-out rate, the TAD and calTAD (Tip Apex distance) of three different implants. An overall cut-out rate of 2.5% (n = 6) was observed. The cut-out rate was 1.2% (n = 1) in the Proximal Femur Nail Antirotation (PFNA) group, 3.7% (n = 3) in the Gamma Nail group and 2.9% (n = 2) in the Gamma3\u00ae with a U-Blade (RC) lag-screw group. The TAD and calTAD differed between the cut-out and non-cut group\u201420.0 mm vs. 18.5 mm and 13.1 mm vs. 15.3 mm, respectively. A significantly higher TAD of 32.5 mm could be seen in the cut-out after PFNA (p &lt; 0.0001). The only significant change in follow-up using Parker\u2019s ratio was observed in the PFNA group (p &lt; 0.0001). The rate of patients requiring surgery after complications was 8.4% (n = 20) without any significant difference between the three groups. The PFNA blade showed significant migration within the femoral head, however the cut-out rate remained the smallest compared to Gamma3 with or without additional U-Blade (RC) lag screw.<\/jats:p>","DOI":"10.3390\/jcm8050615","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T11:22:35Z","timestamp":1557400955000},"page":"615","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Migration of the Lag Screw after Intramedullary Treatment of AO\/OTA 31.A2.1-3 Pertrochanteric Fractures Does Not Result in Higher Incidence of Cut-Outs, Regardless of Which Implant Was Used: A Comparison of Gamma Nail with and without U-Blade (RC) Lag Screw and Proximal Femur Nail Antirotation (PFNA)"],"prefix":"10.3390","volume":"8","author":[{"given":"Nikolaus Wilhelm","family":"Lang","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Breuer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannes","family":"Beiglboeck","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Department: Medical School, University College London, London WC1E 6BT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Hajdu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6321-1804","authenticated-orcid":false,"given":"Reinhard","family":"Windhager","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Orthopedics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9739-6176","authenticated-orcid":false,"given":"Harald Kurt","family":"Widhalm","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s00113-015-0007-x","article-title":"Pertrochanteric femoral fractures in the elderly","volume":"118","author":"Sandmann","year":"2015","journal-title":"Unfallchirurg"},{"key":"ref_2","first-page":"128","article-title":"Implant options for the treatment of intertrochanteric fractures of the hip: Rationale, evidence, and recommendations","volume":"99","author":"Baumgaertner","year":"2017","journal-title":"Bone Joint J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/S0020-1383(17)30776-3","article-title":"Late postoperative analysis of the tip-apex distance (TAD) in pertrochanteric fractures: Is there an accommodation of the implant within the bone?","volume":"48","author":"Jun","year":"2017","journal-title":"Injury"},{"key":"ref_4","first-page":"40","article-title":"A comparison of two fixation methods for femoral trochanteric fractures: A new generation intramedullary system vs sliding hip screw","volume":"14","author":"Carulli","year":"2017","journal-title":"Clin. 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Traumatol. Surg. Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/5\/615\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:49:35Z","timestamp":1760186975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/5\/615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,7]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["jcm8050615"],"URL":"https:\/\/doi.org\/10.3390\/jcm8050615","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,7]]}}}