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proximal femoral nail

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https://www.readbyqxmd.com/read/28186871/augmentation-of-proximal-femoral-nail-in-unstable-trochanteric-fractures
#1
Wasudeo M Gadegone, Bhaskaran Shivashankar, Vijayanad Lokhande, Yogesh Salphale
INTRODUCTION: Biomechanically proximal femoral nail (PFN) is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. MATERIAL AND METHODS: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28178228/imaging-evaluation-of-the-safe-region-for-distal-locking-screw-of-proximal-femoral-nail-anti-rotation-in-patients-with-proximal-femoral-fracture
#2
Jinpeng Gong, Pengcheng Liu, Ming Cai
BACKGROUND Proximal femoral nail anti-rotation (PFNA) is a standard femoral intertrochanteric fracture operation. Iatrogenic vascular injury, although uncommon, is a reported complication of PFNA surgery as well as a complication of hip fracture surgery. This study aimed to compare the safety and best use of the distal locking screw in 170 mm PFNA and 240 mm PFNA devices, and to determine the safe region for placement of the distal locking screw in PFNA surgery. MATERIAL AND METHODS A retrospective analysis of 100 patients with 170 mm PFNA and 80 patients with 240 mm PFNA were retrospectively analyzed...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28164049/a-case-report-of-bisphosphonate-induced-bilateral-osteoporotic-subtrochanteric-fracture-femurii-review-of-literature
#3
Rajendra Uppin, Srinath Gupta, Shivank Prakash
INTRODUCTION: Osteoporosis is a significant health-care problem characterized by excessive skeletal fragility, susceptibility to low-trauma fractures in men as well as women. Any abnormality of the bone that reduces the strength of the bone predisposes it to mechanical failure during normal activity or with minimum trauma. The mechanical failure manifests itself as a fracture, and this fracture must be recognized as a pathological fracture if the patient is to be treated properly. Osteoporosis is one of the leading causes of such pathological fractures and accounts for 1...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28134676/strategies-for-proximal-femoral-nailing-of-unstable-intertrochanteric-fractures-lateral-decubitus-position-or-traction-table
#4
Mesut Mehmet Sonmez, Savas Camur, Erden Erturer, Meric Ugurlar, Adnan Kara, Irfan Ozturk
BACKGROUND: The aim of this prospective randomized study was to compare the traction table and lateral decubitus position techniques in the management of unstable intertrochanteric fractures. METHODS: Eighty-two patients with unstable intertrochanteric fractures between 2011 and 2013 were included in this study. All patients were treated surgically with the Proximal Femoral Nail Antirotation implant (DePuy Synthes). Patients were randomized to undergo the procedure in the lateral decubitus position (42 patients) or with the use of a traction table (40 patients)...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#5
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28116256/a-technical-note-for-extracting-an-incarcerated-femoral-kuntscher-nail
#6
Marí R, Valverde Vilamala D, León García A, Guirro P, Marqués López F
INTRODUCTION: The use of the Kuntscher nail has been the most important advancement in trauma surgery. One of the problems is the difficulty to remove it. A new extraction technique is described in the present case report. CASE REPORT: A 46-year-old man was referred for hip osteoarthritis. He had an acetabulum fracture and a femoral shaft fracture treated 30 years ago with a reamed Kuntscher femoral nail. Lateral hip approach was performed and after attempting to remove the nail with the specific tools being unsuccessful we decided to be more aggressive...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28097113/clinical-and-functional-outcomes-of-treatment-for-type-a1-intertrochanteric-femoral-fracture-in-elderly-patients-comparison-of-dynamic-hip-screw-and-proximal-femoral-nail-antirotation
#7
Hong Man Cho, Kyujung Lee
PURPOSE: We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) treatment of AO type 1 intertrochanteric fractures in elderly patients. MATERIALS AND METHODS: We retrospectively reviewed 194 consecutive patients with type A1 intertrochanteric femoral fractures who were treated with DHS (n=113) or PFNA (n=81). We evaluated operation time, intraoperative blood loss, and functional outcomes, walking ability, and the Barthel activities index...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28094687/successful-management-of-femoral-trauma-in-a-through-knee-amputee-with-a-previous-malunited-fracture-implications-and-functional-outcome
#8
Beth Lineham, Paul Harwood, Peter Giannoudis
BACKGROUND: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management. Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation. Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#9
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28050546/medial-migration-of-the-intramedullary-gamma-3-nail-a-case-report
#10
Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28041612/evaluation-of-a-routine-follow-up-visit-after-an-internal-fixation-of-proximal-femoral-fracture
#11
Joonas Mm Kuorikoski, Tim P Söderlund
BACKGROUND AND PURPOSE: Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. PATIENTS AND METHODS: A retrospective study of 428 consecutive patients (431 fractures) with a scheduled outpatient clinic visit after internal fixation of proximal femoral fractures in a single hospital during years 2012-2013...
February 2017: Injury
https://www.readbyqxmd.com/read/28040074/the-art-of-trochanteric-fracture-reduction
#12
Roland Biber, Johanna Berger, Hermann Josef Bail
The name of Ender is primarily associated with the Ender nails, which were popular for trochanteric fracture fixation more than thirty years ago. However, Ender's concepts were not limited to the implant. Ender developed a unique classification system for trochanteric and subtrochanteric fractures, which provided the theory for closed reduction maneuvers that made the method so successful in his hands. While Ender's nails have become history in the meantime, his principles of fracture reduction can be readily applied on surgery with modern implants such as proximal femoral nails...
December 2016: Injury
https://www.readbyqxmd.com/read/28032707/surgical-technique-for-subtrochanteric-fracture-of-femur
#13
Peng-Cheng Wang, Dong Ren, Chao-Hui Song, Bing Zhou
A 56-year-old woman had fell over herself 4 h prior to her presentation to our hospital. The diagnosis was a subtrochanteric fracture of the right femur (AO-32-A3). The patient was placed in a supine position was set up on a fracture traction table after general anesthesia. The right leg was placed in abduction while the left leg was positioned so that there was flexion of the knee and hip joint. The C-arm was placed on the left side. The surgical field was sterilized and draped. Deformity and external rotation are always present for this type of fracture, so the first step was to place a joystick in the proximal fragment to correct the external rotation...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#14
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27889112/risk-factors-for-cut-out-of-double-lag-screw-fixation-in-proximal-femoral-fractures
#15
Kadir Buyukdogan, Omur Caglar, Samet Isik, Mazhar Tokgozoglu, Bulent Atilla
OBJECTIVE: We assessed factors associated with cut-out after internal fixation of proximal femoral fractures using double lag screw nails. DESIGN: Retrospective cohort study. SETTING: A university hospital. PATIENTS AND METHODS: Patients with non-pathological intertrochanteric femur fractures and a minumum 90days follow-up who underwent internal fixation with dual lag screw nails were included. Potential risk factors for lag screw cut-out investigated by our study were: age, gender, body mass index, comorbidities (American Society of Anesthesiologists [ASA] classification), type of fracture (AO/OTA classification), fracture stability, side, operation time, implant length, reduction quality, tip-apex distance (TAD), and lag screw configuration...
February 2017: Injury
https://www.readbyqxmd.com/read/27875489/femoral-medialization-fixation-failures-and-functional-outcome-in-trochanteric-hip-fractures-treated-with-either-a-sliding-hip-screw-or-an-intramedullary-nail-from-within-a-randomized-trial
#16
Christopher P Bretherton, Martyn J Parker
OBJECTIVES: The aim of this study was to determine if femoral medialization influences residual pain and mobility and to determine if fixation method or fracture pattern influences the tendency to medialize. DESIGN: This study used data from within a randomized controlled trial. SETTING: Peterborough City Hospital, UK. PATIENT/PARTICIPANTS: Eight hundred forty-four patients presenting with a trochanteric hip fracture were randomized...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27843357/proximal-femoral-fracture-surgery-in-a-patient-with-osteopetrosis-tarda-complications-and-treatment-strategy
#17
Fırat Seyfettinoglu, Ümit Tuhanioğlu, Hasan Ulas Ogur, Hakan Cicek
Osteopetrosis is a rare, inherited disease characterized by defects in osteoclastic function that results in defective bone resorption. When fractures are encountered, fixation is extremely difficult. Osteopetrosis patients have an increased predisposition to infection. If infection develops after a fracture, treatment is more difficult. In this paper, treatment is presented of a 49-year old female to whom proximal femoral nailing was applied for fixation of an osteopetrotic proximal femur fracture; and when it was unsuccessful, revision was made with a locked anatomic plate, which subsequently led to development of infection...
2016: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/27810151/markers-of-muscle-damage-for-comparing-soft-tissue-injury-following-proximal-femur-nail-and-dynamic-hip-screw-operations-for-intertrochanteric-hip-fractures
#18
Yonathan Wagman, Ortal Segal, Israel Dudkiewicz, Ely Steinberg
BACKGROUND: Femoral neck fractures are the most common fractures among the elderly. The two operative approaches used for the treatment of AO/OTA 31 intertrochanteric fractures include an intramedullary device (proximal femoral nail [PFN]) or an extramedullary device (sliding/dynamic hip screw [DHS]). The aim of this study was to provide objective evidence of local soft tissue injury by measuring serum creatine phosphokinase (CPK), a biochemical marker, to quantify muscle damage and inflammation in patients treated by the two approaches...
December 2016: Injury
https://www.readbyqxmd.com/read/27789875/biomechanical-analysis-of-the-cephalomedullary-nail-versus-the-trochanteric-stabilizing-plate-for-unstable-intertrochanteric-femur-fractures
#19
David Walmsley, Bruce Nicayenzi, Paul Rt Kuzyk, Alan Machin, Habiba Bougherara, Emil H Schemitsch, Radovan Zdero
Unstable intertrochanteric fractures are commonly treated with a cephalomedullary nail due to high failure rates with a sliding hip screw. The Omega3 Trochanteric Stabilizing Plate is a relatively new device that functions like a modified sliding hip screw with a proximal extension; however, its mechanical properties have not been evaluated. This study biomechanically compared a cephalomedullary nail, that is, Gamma3 Nail against the Omega3 plate. Unstable intertrochanteric fractures were created in 24 artificial femurs...
October 26, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27780504/treatment-of-osteoporotic-intertrochanteric-fractures-by-zoledronic-acid-injection-combined-with-proximal-femoral-nail-anti-rotation
#20
Yong Li, Wen-Bo Zhao, De-Li Wang, Qing He, Qin Li, Fu-Xing Pei, Lei Liu
OBJECTIVE: To observe the clinical results of proximal femoral nail anti-rotation (PFNA) combined with zoledronic acid injection in the treatment of osteoporotic intertrochanteric fractures in the elderly. METHODS: 60 elderly patients with osteoporotic intertrochanteric fractures were diagnosed using a dual energy X-ray bone density instrument. Patients were randomly divided into treatment or control groups (30 cases in each group). Patients in both groups were treated by closed/open reduction and internal fixation using PFNA...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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