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Trochanteric Nail

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https://www.readbyqxmd.com/read/29896464/failure-of-a-rotation-control-gamma-3-lag-screw-used-to-treat-a-trochanteric-fracture
#1
Kyungho Choi, Yongtae Kim, Shicheng Zhou, Jihyo Hwang
Gamma 3 rotation control lag screws (U-blade) are particularly useful when treating rotational and unstable fractures of the proximal femur. A 93-year-old woman who underwent closed reduction of a trochanteric fracture and internal fixation with a Gamma 3 nail rotation control lag screw. The patient presented with metal failure and U-blade bending following a fall occurring 4 weeks after surgery. Here, we present a case report summarizing removal of the failed lag screw.
June 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29804880/nail-or-plate-fixation-for-a3-trochanteric-hip-fractures-a-systematic-review-of-randomised-controlled-trials
#2
Martyn Parker, Pradyumna Raval, Jan-Erik Gjertsen
Continuing controversy exists for the choice of implant for treating A3 trochanteric hip fractures so we undertook a systematic review of randomised controlled trials from the year 2000 onwards that have compared an intramedullary nail with an extramedullary fixation implant for the treatment of these fractures. Data on the occurrence of any fracture healing complications was extracted and the results combined to calculate Peto odd ratio. Nine studies involving 370 fractures were identified. Three studies involving 105 fractures compared an intramedullary nail with a static fixation (condylar, blade or locking plate)...
May 22, 2018: Injury
https://www.readbyqxmd.com/read/29791709/sub-trochanteric-hip-fracture-following-core-decompression-for-osteonecrosis-in-a-patient-with-a-pre-existing-contralateral-occult-femoral-neck-fracture
#3
Ryan J Berger, Assem A Sultan, Connor Cole, Nipun Sodhi, Anton Khlopas, Michael A Mont
We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29786824/intramedullary-nail-with-integrated-cephalocervical-screws-in-the-intertrochanteric-fractures-treatment-position-of-screws-in-fracture-stability
#4
Gökhan Kaynak, Mehmet Can Ünlü, Mehmet Fatih Güven, Ozan Ali Erdal, Okan Tok, Hüseyin Botanlıoğlu, Önder Aydıngöz
BACKGROUND: Stable fracture fixation is important in the treatment of intertrochanteric femur (ITF) fractures in the elderly population to prevent the loss of reduction, achieve early mobility, and restore independence. The aim of this study was to present the results of surgical treatment of stable and unstable ITF fractures using a trochanteric antegrade intramedullary nail with two cephalocervical screws in an integrated mechanism (Intertan®; Smith & Nephew, Memphis, TN) and evaluate the relationship between the loss of reduction and screw position in the femoral neck in two planes...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29740525/a-survey-of-current-practices-and-preferences-for-internal-fixation-of-trochanteric-fractures-of-the-femur-in-brazil
#5
Vincenzo Giordano, Denner N Ribeiro, Rafael G Tinoco, Thiago A Alvim, Marcos Giordano, Anderson Freitas, Hilton A Koch
Objective The primary aim of this study was to survey current practices and preferences behind internal fixation of trochanteric femoral fractures among Brazilian orthopedic surgeons. The secondary aim was to identify the main reason for these preferences. Methods A survey containing 20 images of trochanteric fractures of the femur was presented to a group of 62 orthopedists, all members of the Brazilian Society of Orthopedics and Traumatology (SBOT). The first part of the questionnaire was created to identify the surgeons' degree of professional experience, type of practice, and areas of greatest interest and performance within the specialty...
March 7, 2018: Curēus
https://www.readbyqxmd.com/read/29724590/cement-augmentation-of-the-proximal-femoral-nail-antirotation-pfna-a-multicentre-randomized-controlled-trial
#6
Christian Kammerlander, Einar S Hem, Tim Klopfer, Florian Gebhard, An Sermon, Michael Dietrich, Olaf Bach, Yoram Weil, Reto Babst, Michael Blauth
INTRODUCTION: New implant designs like the Proximal Femoral Nail Antirotation (PFNA) were developed to reduce failure rates in unstable pertrochanteric fractures in the elderly. Standardized implant augmentation with up to 6 mL of polymethylmethacrylate (PMMA) cement has been introduced to enhance implant anchorage by increasing the implant-bone interface in osteoporotic bone conditions. Biomechanically, loads to failure were significantly higher with augmentation. The primary objective of this study was to compare the mobility of patients with closed unstable trochanteric fractures treated by PFNA either with or without cement augmentation...
April 22, 2018: Injury
https://www.readbyqxmd.com/read/29720223/greater-rate-of-cephalic-screw-mobilisation-following-proximal-femoral-nailing-in-hip-fractures-with-a-tip-apex-distance-tad-and-a-calcar-referenced-tad-greater-than-25-mm
#7
Rocco Aicale, Nicola Maffulli
BACKGROUND: To ascertain whether the tip-apex distance (TAD), calcar referenced TAD (CalTAD), and the sum of both (TADcalTAD) are predictive measurements of mobilisation of the cephalic screw in patients with trochanteric hip fractures. METHODS: Between 2014 and 2015, 68 patients (mean age 86 years, 45 females, 23 males) with a trochanteric hip fracture underwent intramedullary nailing. The TAD and CalTAD were measured, and for each parameter, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)...
May 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29644290/posterior-dislocation-of-a-native-hip-joint-associated-with-ipsilateral-per-trochanteric-fracture-a-rare-case-report
#8
Mazin Fageir, Manoj Kumar Puthiyavaniya Veettil
We describe a case of traumatic posterior dislocation of a native hip joint associated with ipsilateral comminuted inter-trochanteric femoral fracture. In our case, closed reduction was attempted but proved unsuccessful. Taking into account the planned subsequent intra-medullary femoral nail, open reduction through a lateral incision was undertaken. Post-operatively, the planned mobility was for a non-weight bearing period of 6 weeks followed by a partial-weight bearing period of 6 weeks before progressing to full-weight bearing...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29600203/isolated-spontaneous-atraumatic-avulsion-of-lesser-trochanter-of-femur-a-pathognomonic-sign-of-malignancy-in-adults-a-case-report-and-review-of-literature
#9
Prasoon Kumar, Saurabh Agarwal, Rajesh Kumar Rajnish, Vishal Kumar, Karan Jindal
Introduction: Avulsion fractures of lesser trochanter (LT) of femur are generally seen following trauma with intertrochanteric or sub trochanteric fractures. Non-traumatic fractures of LT could oc-cur due to sudden violent contraction of the iliopsoas muscle that inserts on the LT; during vigorous exercise, or sudden pull involving flexion of hip. These are seen commonly in adolescents where the physis has not fused yet. Such a scenario in an adult patient most often or not leads to a diagnosis of an underlying malignancy or metastatic lesion...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29560397/biarticular-total-femur-spacer-for-massive-femoral-bone-loss-the-mobile-solution-for-a-big-problem
#10
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29432318/helical-blade-or-the-integrated-lag-screws-a-matched-pair-analysis-of-100-patients-with-unstable-trochanteric-fractures
#11
Ashok S Gavaskar, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan, Bhupesh Karthik, Santosh S
OBJECTIVES: To compare the radiological and clinical results with PFNA-II and InterTan in the treatment of unstable trochanteric fractures in the elderly. DESIGN: Retrospective, multicenter, matched pair. SETTING: Three tertiary level trauma centers. PATIENTS: Hundred elderly patients who underwent intramedullary stabilization with either the PFNA-II or the InterTan for osteoporotic unstable trochanteric fractures. INTERVENTIONS: Fifty matched pairs consisting of OTA/AO-A2 and A3 fractures were created from a cohort of 290 patients who underwent internal fixation for unstable trochanteric fractures with the PFNA-II or InterTan nails...
June 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29397996/trochanteric-fracture-implant-motion-during-healing-a-radiostereometry-rsa-study
#12
Alicja J Bojan, Anders Jönsson, Hans Granhed, Carl Ekholm, Johan Kärrholm
Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail...
March 2018: Injury
https://www.readbyqxmd.com/read/29326764/a-prospective-study-to-evaluate-the-management-of-sub-trochanteric-femur-fractures-with-long-proximal-femoral-nail
#13
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29318087/treatment-with-helical-blade-cephalomedullary-nail-for-two-part-basicervical-proximal-femoral-fracture-in-elderly-patients-a-retrospective-observational-study
#14
Ichiro Okano, Takatoshi Sawada, Nobumasa Kushima, Tetsuya Tachibana, Katsunori Inagaki
Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29244689/trochanteric-femoral-fracture-around-a-birmingham-hip-resurfacing-prosthesis-a-case-report-and-review-of-the-literature
#15
Daud Tai Shan Chou, Ben Davis
CASE: A traumatic nondisplaced periprosthetic trochanteric fracture around a well-fixed and functioning Birmingham Hip Resurfacing prosthesis was managed with a reconstruction intramedullary nail. The surgical procedure provided excellent pain relief, and the patient was able to mobilize with crutches the day after surgery. Follow-up at 1 year confirmed excellent clinical and radiographic results. CONCLUSION: In a patient with a previously well-functioning hip resurfacing prosthesis, internal fixation rather than revision hip arthroplasty can offer good clinical and radiographic outcomes...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29221656/z-effect-after-intramedullary-nailing-systems-for-trochanteric-femur-fractures
#16
S J M Smeets, G Kuijt, P V van Eerten
PURPOSE: The aim of this study was to investigate the incidence of Z-effect after dual lag screw intramedullary nailing systems and risk factors contributing to this effect. We hypothesized that long nails provide more neck strength due to a longer lever than short nails and are therefore less likely to develop a misbalance of a higher head compressive strength than neck compressive strength. METHODS: In this retrospective cohort study 103 patients treated operatively with a dual lag screw intramedullary nailing device for (sub)trochanteric hip fracture were included...
December 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29182125/locked-rigid-antegrade-intramedullary-nailing-of-adolescent-femoral-fractures-using-a-lateral-trochanteric-entry-point
#17
M Hampton, N Maripuri, S Khandekar, S Giles, J Fernandes, S Jones
The purpose of this study is to present our experience of treating adolescent femoral fractures using a locked intramedullary nail with a lateral trochanteric entry point. We retrospectively reviewed 15 femoral fractures in 13 adolescents who were treated in our unit between 2011 and 2014. Data collected included patient demographics, mechanism of injury, type of fracture, associated injuries, time to union and complications. A radiographic review was also undertaken. The mean time to radiological union in 14 out of the 15 fractures was 13 weeks (range, 10-20 weeks)...
December 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29173962/intraoperative-lateral-wall-fractures-during-dynamic-hip-screw-fixation-for-intertrochanteric-fractures-incidence-causative-factors-and-clinical-outcome
#18
Annur R Pradeep, Addala KiranKumar, Jayaramaraju Dheenadhayalan, Shanmuganathan Rajasekaran
INTRODUCTION: The intact lateral wall plays a key role in stabilization of trochanteric fracture. Hence extreme precaution should be taken to prevent lateral wall damage during DHS fixation. Present study is aimed at evaluating the determinants of lateral wall fracture and its effect on outcome in intertrochanteric fracture femur treated with DHS. MATERIAL AND METHODS: This is a prospective study involving intertrochanteric fractures treated with DHS fixation from July 2013 to June 2014...
February 2018: Injury
https://www.readbyqxmd.com/read/29162265/the-impact-of-antegrade-intramedullary-nailing-start-site-using-the-sign-nail-in-proximal-femoral-fractures-a-prospective-cohort-study
#19
Mohamed Mustafa Diab, Hao-Hua Wu, Edmund Eliezer, Billy Haonga, Saam Morshed, David W Shearer
INTRODUCTION: In many low and middle-income countries (LMICs) SIGN nail is commonly used for antegrade femoral intramedullary (IM) nailing, using a start site either at the tip of the greater trochanter or piriformis fossa. While a correct start site is considered an essential technical step; few studies have evaluated the impact of using an erroneous start site. This is particularly relevant in settings with limited access to fluoroscopy to aid in creating a nail entry point. The purpose of this study was to evaluate the impact of antegrade SIGN IM nailing start site on radiographic alignment and health-related quality of life...
February 2018: Injury
https://www.readbyqxmd.com/read/29157107/the-impact-of-surgery-for-trochanteric-femur-fracture-on-sexuality-in-men-and-their-female-partners
#20
Melih Balci, Deniz Cankaya, Altug Tuncel, Burak Yoldas, Ozer Guzel, Cagdas Senel
PURPOSE: This study was aimed to investigate the effects of trochanteric femur fracture treatment methods on erectile functions of the patients and on sexual functions with their female partners. MATERIALS AND METHODS: A total of 43 patients with trochanteric femur fracture who underwent proximal femoral nail (PFN) or proximal femur locking compression plate (PF-LCP) surgery were included in the study. The PFN implant was applied to group 1 ( n = 23) and the PF-LCP implant to group 2 ( n = 20)...
September 2017: Journal of Orthopaedic Surgery
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