Publication: A comparative study between the standard AO method and fibula length measurement in estimating maximum femoral nail length
Loading...
Date
2022
Authors
Sandhu, Manharpreet Singh
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction Diaphyseal femur fractures are a common presentation in orthopaedics and are routinely managed with intramedullary fixation. Appropriate nail length and size is required to be measured preoperatively. Maximum nail length can be estimated by measuring either clinically or radiographically the contralateral femur or by using forearm referencing. However, these methods are inadequate when patients present with bilateral femoral bone fractures with concurrent forearm fractures. The aim of this study is to identify another reliable clinical method in estimating the maximum femoral nail length. Materials and methods A total of 140 patients who attended the Orthopaedic clinics and wards at Hospital Universiti Sains Malaysia (HUSM) that met the inclusion and exclusion criteria were chosen using a convenience sampling method and participated in this cross-sectional study. Their estimated maximum femoral nail length (EFNL) and fibula length were measured using a tailor measuring tape on the ipsilateral limb. The EFNL was measured according to the standard AO method while the fibula was measured from the tip of the fibula head to the tip pf the lateral malleolus. These data were collected and analyzed using SPSS version 26. Descriptive statistics was used to summarize the socio-demographic characteristics of the subjects. Numerical data were presented as mean (SD) or median (IQR) based on their normality distribution, while categorical data were presented as frequency (percentage). Results Of the 140 patients measured, the overall mean EFNL was 37.98cm (± 2.72cm) while the fibula length was 37.72cm (± 2.61cm). The Pearson’s Correlation analysis showed that the fibula length was highly correlated with the EFNL, and this correlation was not influenced by age, BMI or gender. Interclass correlation analysis (ICC) showed high degree of inter-observer reliability in the both the femur (ICC 0.938 with a 95% confidence interval) and fibula (ICC 0.972 with a 95% confidence interval) measurements. A formula for estimating maximum femoral nail length was derived from the correlation graph. Estimated maximum femoral nail length = 1 + (0.98 × fibula length) Conclusion The fibula length is shown to correlate well with the clinical measurement of EFNL in this study and can be used as a reliable alternative clinical method to estimate the maximum femoral nail length
Description
Keywords
Diaphyseal femur fracture , Intramedullary nail length