Retrospective cohort study of 77 cephalomedullary-nailed proximal femoral fractures testing whether CalTAD — a modified tip-apex measurement referenced to the calcar — predicts lag screw cut-out better than traditional TAD and other radiographic parameters.
When placing a cephalomedullary nail, target inferior-central lag screw positioning and verify CalTAD rather than relying on traditional TAD alone — CalTAD is the only measurement that survives multivariate scrutiny, rewards the biomechanically superior inferior position, and carries a potential cut-off of < 21 mm to guide intraoperative decision-making.
Retrospective cohort study of 77 cephalomedullary-nailed proximal femoral fractures testing whether CalTAD — a modified tip-apex measurement referenced to the calcar — predicts lag screw cut-out better than traditional TAD and other radiographic parameters.
When placing a cephalomedullary nail, target inferior-central lag screw positioning and verify CalTAD rather than relying on traditional TAD alone — CalTAD is the only measurement that survives multivariate scrutiny, rewards the biomechanically superior inferior position, and carries a potential cut-off of < 21 mm to guide intraoperative decision-making.