Radiographic Predictors of Screw Cutout for Intertrochanteric Fractures Treated With Cephalomedullary Nails

The objective of this study was to determine the predictive value of tip-apex distance (TAD) and Parker\u27s ratio for screw cutout after treatment of intertrochanteric hip fractures with a long cephalomedullary nail. A total of 97 patients with AO/OTA 31-A1-A3 intertrochanteric fractures and a minimum follow-up of 8 weeks were included. Increased Parker\u27s ratio on the anteroposterior radiograph (OR = 1.386, p \u3c .003) and lateral radiograph (OR = 1.138, p \u3c .028) was significantly associated with screw cutout. In a multivariable regression analysis, only the Parker\u27s anteroposterior ratio was significantly associated with risk of screw cutout (OR = 1.393, p = .004), but TAD (OR = 0.977, p = .764) and Parker\u27s lateral ratio (OR 1.032, p = .710) were not independent predictors of cutout. The study concluded that Parker\u27s anteroposterior ratio is the most helpful measurement in predicting screw cutout. (Journal of Surgical Orthopaedic Advances 28(2):115-120, 2019)