Femoral offset following trochanteric femoral XXXX : a prospective observational study.

@entity1 @entity173 @entity174
BACKGROUND: Reconstruction of the femoral offset reportedly improves outcome following total hip arthroplasty, but little is known of its influence following hip @entity174 . We aimed to establish the effect of the femoral offset on the medium-term functional outcome in elderly @entity1 who had sustained @entity173 requiring proximal femoral nailing. @entity1 AND METHODS: We measured the rotation corrected femoral offset (FORC) and relative femoral offset (FORL) on plain anteroposterior radiographs of the hip in 188 @entity1 (58 male, 130 female) with a @entity173 who underwent proximal femoral nailing at our institution. The primary outcome measure was the Harris hip score (HSS) 6 and 12 months postoperatively; the Barthel index was assessed as a secondary outcome. RESULTS: The mean FORC after surgery was 58 mm (  11 mm), while the mean FORL was 1.21 (  0.22). At final follow up, we found significant inverse relationships (Spearman's rank correlation coefficient,   ) between FORC and FORL and the functional outcome assessed by the HSS (FORC:    = -0.207, p = 0.036; FORL:    = -0.247, p = 0.012), and FORL and the Barthel index (FORC:    = -147, p = 0.129; FORL:    = -0.192, p = 0.046). A consistent trend was observed after adjustment for confounding variables. CONCLUSIONS: Our results underline the biomechanical importance of the femoral offset for medium-term outcomes in elderly @entity1 with @entity173 . In contrast with the published findings on total hip arthroplasty, we found an inverse correlation between functional outcome and the extent of the reconstructed femoral offset. LEVEL OF EVIDENCE: Level I - Prognostic study.
