title: Incidence and radiologic outcome of intraoperative lateral wall fractures in OTA 31A1 and A2 fractures treated with cephalomedullary nailing.
abstract: OBJECTIVE
  To determine the incidence of intraoperative lateral wall fracture in OTA 31A1 and A2 fractures treated with a cephalomedullary nail and to determine whether this contributed to the failure of treatment.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A cohort of 291 patients (31.A1/A2-231, A3-60) was assessed with pre- and postoperative radiographs. Patients with intact lateral wall fractures were included in the study. One hundred sixty-five of 231 patients (77%) completed radiologic follow-up. They were divided into 2 groups. Group 1 (129 patients, 78%) consisted of patients with an intact lateral wall postoperatively. Group 2 (36 patients, 22%) consisted of patients who sustained lateral wall fracture intraoperatively (FLW).
  
  
  METHODS
  Closed reduction and intramedullary nail insertion.
  
  
  METHODS
  Rate of failure/reoperation and collapse were compared between the groups.
  
  
  RESULTS
  The incidence of intraoperative lateral wall fracture was 21% (48 of 165). Fracture collapse and failure rate were not statistically significant in either groups (group 1: 1%, group 2: 5%).
  
  
  CONCLUSIONS
  The incidence of intraoperative lateral wall fracture in OTA 31A1 and A2 pertrochanteric fractures after cephalomedullary nailing is similar to sliding hip screws. The presence of lateral wall fracture did not adversely affect healing of pertrochanteric fractures.
  
  
  METHODS
  Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: P R J V C
authors.initials: PR
authors.lastname: Boopalan
authors.forename: Jong-Keon
authors.initials: JK
authors.lastname: Oh
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Kim
authors.forename: Chang-Wug
authors.initials: CW
authors.lastname: Oh
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Cho
authors.forename: Won-Yong
authors.initials: WY
authors.lastname: Shon
mesh_terms: D000368:Aged; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome