Fractures around Trochanteric Nails: The "Vergilius Classification System". 2021

Giuseppe Toro, and Antimo Moretti, and Daniele Ambrosio, and Raffaele Pezzella, and Annalisa De Cicco, and Giovanni Landi, and Nicola Tammaro, and Pasquale Florio, and Antonio Benedetto Cecere, and Adriano Braile, and Antonio Medici, and Antonio Siano, and Bruno Di Maggio, and Giampiero Calabrò, and Nicola Gagliardo, and Ciro Di Fino, and Gaetano Bruno, and Achille Pellegrino, and Giacomo Negri, and Vincenzo Monaco, and Michele Gison, and Antonio Toro, and Alfredo Schiavone Panni, and Umberto Tarantino, and Giovanni Iolascon
Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy.

BACKGROUND The fractures that occurred around trochanteric nails (perinail fractures, PNFs) are becoming a huge challenge for the orthopaedic surgeon. Although presenting some specific critical issues (i.e., patients' outcomes and treatment strategies), these fractures are commonly described within peri-implant ones and their treatment was based on periprosthetic fracture recommendations. The knowledge gap about PNFs leads us to convene a research group with the aim to propose a specific classification system to guide the orthopaedic surgeon in the management of these fractures. METHODS A steering committee, identified by two Italian associations of orthopaedic surgeons, conducted a comprehensive literature review on PNFs to identify the unmet needs about this topic. Subsequently, a panel of experts was involved in a consensus meeting proposing a specific classification system and formulated treatment statements for PNFs. Results and Discussion. The research group considered four PNF main characteristics for the classification proposal: (1) fracture localization, (2) fracture morphology, (3) fracture fragmentation, and (3) healing status of the previous fracture. An alphanumeric code was included to identify each characteristic, allowing to describe up to 54 categories of PNFs, using a 3- to 4-digit code. The proposal of the consensus-based classification reporting the most relevant aspects for PNF treatment might be a useful tool to guide the orthopaedic surgeon in the appropriate management of these fractures.

UI MeSH Term Description Entries

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