Author/Authors :
Iolascon, Giovanni Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Toro, Giuseppe Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Moretti, Antimo Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Cicco, Annalisa De Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Landi, Giovanni Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Tammaro, Nicola Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Cecere, Antonio Benedetto Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Braile, Adriano Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Bruno, Gaetano Unit of Orthopaedics and Traumatology - AORN Sant’Anna e San Sebastiano - Caserta, Italy , Panni, Alfredo Schiavone Department of Medical and Surgical Specialties and Dentistry - University of Campania “Luigi Vanvitelli” - Naples, Italy , Ambrosio, Daniele Unit of Orthopaedics and Traumatology - Evangelical Hospital Betania - Naples, Italy , Florio, Pasquale Unit of Orthopaedics and Traumatology - Evangelical Hospital Betania - Naples, Italy , Pezzella, Raffaele Department of Life Health & Environmental Sciences - University of L’Aquila - Unit of Orthopaedics and Traumatology - L’Aquila, Italy , Medici,Antonio Unit of Orthopaedics and Traumatology - AORN S. Giuseppe Moscati - Avellino, Italy , Siano, Antonio Unit of Orthopaedics and Traumatology - Santa Maria Della Speranza Hospital - Battipaglia, Italy , Maggio, Bruno Di Unit of Orthopaedics and Traumatology - “Ave Gratia Plena” Civil Hospital - Piedimonte Matese, Italy , Calabr`o, Giampiero Unit of Orthopaedics and Traumatology - San Francesco D’Assisi Hospital - Oliveto Citra, Italy , Gagliardo, Nicola Unit of Orthopaedics and Traumatology - San Giuliano Hospital - Giugliano, Italy , Fino, Ciro Di Unit of Orthopaedics and Traumatology - AOR San Carlo - Potenza, Italy , Pellegrino, Achille Unit of Orthopaedics and Traumatology - San Giuseppe Moscati Hospital - Aversa, Italy , Negri, Giacomo Unit of Orthopaedics and Traumatology - Evangelical Hospital Betania - Naples, Italy , Monaco, Vincenzo Unit of Orthopaedics and Traumatology - Santa Maria Incoronata Dell’Olmo Hospital - Cava de’ Tirreni, Italy , Gison, Michele Unit of Orthopaedics and Traumatology - Villa Malta Hospital - Sarno, Italy , Toro, Antonio Unit of Orthopaedics and Traumatology - Villa Malta Hospital - Sarno, Italy , Tarantino, Umberto Department of Clinical Sciences and Translational Medicine - University of Rome Tor Vergata - Rome, Italy
Abstract :
e fractures that occurred around trochanteric nails (perinail fractures, PNFs) are becoming a huge challenge for theorthopaedic surgeon. Although presenting some specific critical issues (i.e., patients’ outcomes and treatment strategies), these fracturesare commonly described within peri-implant ones and their treatment was based on periprosthetic fracture recommendations. 'eknowledge gap about PNFs leads us to convene a research group with the aim to propose a specific classification system to guide theorthopaedic surgeon in the management of these fractures.Materials and Methods. A steering committee, identified by two Italianassociationsoforthopaedicsurgeons,conductedacomprehensiveliteraturereviewonPNFstoidentifytheunmetneedsaboutthistopic.Subsequently,apanelofexpertswasinvolvedinaconsensusmeetingproposingaspecificclassificationsystemandformulatedtreatmentstatementsforPNFs.Results and Discussion.'eresearchgroupconsideredfourPNFmaincharacteristicsfortheclassificationproposal:(1) fracture localization, (2) fracture morphology, (3) fracture fragmentation, and (3) healing status of the previous fracture. An al-phanumericcodewasincludedtoidentifyeachcharacteristic,allowingtodescribeupto54categoriesofPNFs,usinga3-to4-digitcode.'eproposaloftheconsensus-basedclassificationreportingthemostrelevantaspectsforPNFtreatmentmightbeausefultooltoguidethe orthopaedic surgeon in the appropriate management of these fractures.
