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. 2022 Jul 28;23(1):721.
doi: 10.1186/s12891-022-05689-9.

In response to letter to the editor: calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures

Shi-Min Chang  1 , Wei Mao  2 , Shi-Jie Li  2 , Hui Song  2
Affiliations

In response to letter to the editor: calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures

Shi-Min Chang et al. BMC Musculoskelet Disord. .

Abstract

We appreciate the interest by Drs. Hagiyama and coauthors in our work entitled "Calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures". They discussed several pertinent points and it is our pleasure to respond their concerns in order. Firstly, we agree that calcar fracture gap and anteromedial cortical support are different concepts, though both of them were used to evaluate the displacement of fracture reduction quality. Secondly, our primary outcome parameter was the threshold distance of calcar fracture gapping in anteroposterior and lateral fluoroscopies, which was calculated based on sensitivity and specificity by receiver operating characteristic curves. Thirdly, we took immediate post-operative fluoroscopic images in 3 views to describe the initial reduction quality as baseline to compare and calculate the changes with three-dimensional computed tomography, which was taken about one week after operation for confirming secondary stability after head-neck sliding and impaction. Lastly, the parameters selected in multivariable analysis. Future work with better study-design is needed to improve the prediction of patient outcomes.

Keywords: Anteromedial cortical support; Cephalomedullary nail; Fluoroscopy; Fracture gap; Trochanteric hip fracture.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
Measuring calcar fracture gap and cortical step at the anteromedial inferior corner after fracture reduction and cephalomedullary nailing, using immediate post-operative fluoroscopic image. The proximal nail diameter is used as calibrator
See this image and copyright information in PMC

References

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