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proximal femoral nail

J S Palmer, P Ward
No abstract text is available yet for this article.
March 15, 2018: Annals of the Royal College of Surgeons of England
Chi Zhang, Bo Xu, Guanzhao Liang, Xianshang Zeng, Dan Zeng, Deng Chen, Zhe Ge, Weiguang Yu, Xinchao Zhang
Objectives To compare the functional and radiographic outcomes of InterTAN nail (IT) and proximal femoral nail anti-rotation (PFNA) for managing primary AO/OTA 31-A2 intertrochanteric hip fractures (IHFs) in older osteoporotic patients. Methods Patients aged 60 years or older who received surgical treatment for IHFs (AO/OTA 3.1A2.1-A2.3) with IT or PFNA were retrospectively evaluated. The primary outcome was the postoperative treatment failure rate. The secondary outcome was the Harris Hip Score (HHS). Results A total of 326 osteoporotic cases (326 hips: IT, n = 162; PFNA, n = 164) were assessed with a mean follow-up of 43...
January 1, 2018: Journal of International Medical Research
Jakub J Słowiński, Konrad Kudłacik
Introduction: The treatment of femoral diaphyseal fractures by intramedullary nailing has become a common procedure in orthopaedic surgery. The purpose of this numerical simulation was to present how the changes in configuration of the stabilisation system can affect the stress and displacement state in the bone tissue and implanted device. Material and Methods: The numerical comparison of the stabilisation variants for the type 32-A2 femoral diaphyseal fracture (according to the AO classification) performed by using the Charfix2 (ChM®) anatomical nail locked in a number of chosen ways...
2018: Applied Bionics and Biomechanics
Leo Nherera, Paul Trueman, Alan Horner, Tracy Watson, Alan J Johnstone
BACKGROUND: Intertrochanteric hip fractures are common and devastating injuries especially for the elderly. Surgical treatment is the optimal strategy for managing intertrochanteric fractures as it allows early rehabilitation and functional recovery. The relative effects of internal fixation strategies for intertrochanteric fracture after operation remain limited to relatively small studies which create uncertainty in attempts to establish evidence-based best practice. METHODS: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies to assess the clinical effectiveness of two commonly used intramedullary devices: a twin screw integrated cephalomedullary nail (InterTAN) versus a single screw cephalomedullary nail (proximal femoral nail antirotation) in patients with intertrochanteric fractures...
March 2, 2018: Journal of Orthopaedic Surgery and Research
Florian Sevelda, Wenzel Waldstein, Joannis Panotopoulos, Alexandra Kaider, Philipp Theodor Funovics, Reinhard Windhager
BACKGROUND: The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. QUESTIONS/PURPOSES: In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? METHODS: Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup...
February 14, 2018: Clinical Orthopaedics and related Research
Bohua Li, Jun Li, Shanxi Wang, Lei Liu
The purpose of this study was to quantify the peri-operative blood loss of elderly patients with intertrochanteric fractures treated by unreamed proximal femoral nail anti-rotation (PFNA) and analyze whether the substantial hidden blood loss was induced by initial trauma or the operation. The clinical data of 123 patients with intertrochanteric fracture treated with unreamed PFNA from Jan 2013 to Apr 2017 were analyzed retrospectively. Blood routine on admission day (ADM), pre-operative day one (PRE), post-operative days one and three (POD1 and POD3) and the visible blood loss (VBL) were obtained...
February 19, 2018: Scientific Reports
Fang-Gui Sun, De-Xin Wang, Yu-Tong Hu, Rong-Ming Xu
OBJECTIVE: To explore the curative effect and the recessive loss of blooding of PFNA for the treatment of intertrochanteric fractures of femur. METHODS: From January 2012 to January 2015, a total of 49 patients with intertrochanteric fractures of femur were treated with proximal femoral anti-rotation nail including 41 males and 8 females with an average age of 79 years old ranging from 65 to 91 years old. According to the modified Evans type, 1 case was type I, 12 cases were type II, 36 cases were type III...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Rajesh Govindasamy, Ramkumar Gnanasundaram, Saravanan Kasirajan, Syed Ibrahim, Jimmy Joseph Melepuram
Background: Femoral shaft fractures are an incapacitating pediatric injury accounting for 1.6% of all pediatric bony injuries. Management of these fractures is largely directed by age, fracture pattern, associated injuries, built of the child and socioeconomic status of the family. We retrospectively evaluated the use of elastic stable intramedullary nail (ESIN) in surgical management of femoral shaft fractures in children and its complications. Methods: Fifty two children were treated with titanium elastic nails (TEN) from June 2009 to June 2014 at our institution...
January 2018: Archives of Bone and Joint Surgery
W Wang, S Zhai, X P Han, Y Cui
Objective: To compare the effect of proximal femoral nail anti-rotation and dynamic hip screw in treating the femoral intertrochanteric fractures in elderly patients. Methods: From June 2011 to June 2014, totally 158 elderly patients of femoral intertrochanteric fracture were treated by surgery, among whom 68 cases were treated with dynamic hip screws (DHS), and 90 patients were treated with proximal femoral nail anti-rotation (PFNA). The operative time, hospitalization time, weight-bearing time, fracture-healing time, blood loss and the hip function score after the operation were compared between the two groups by using the t test; and the incidence of the postoperative complication was compared between the two groups by using the Chi square test...
January 30, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
S Coyle, S Kinsella, B Lenehan, J M Queally
BACKGROUND: As healthcare systems come under ever-increasing pressure to provide more care with fewer resources, emphasis is being placed on value-based systems that maximise quality and minimize cost. The aim of this study was to determine which interventions in fracture care have been demonstrated to be cost effective. METHODS: A systemic review of cost-utility studies on the management of fractures from 1976 to 2015 was carried out using a search of the Cost-Effectiveness Analysis Registry, National Health Service Economic Evaluation Database (NHS EED) and MEDLINE...
January 31, 2018: Injury
Shuwei Tian, Zheyuan Shen, Yang Liu, Yanlong Zhang, Aqin Peng
OBJECTIVE: To investigate the effect of tranexamic acid (TXA) on hidden bleeding in older intertrochanteric fracture patients treated with intramedullary nails. METHOD: Between January 2016 and January 2017, 100 cases of intertrochanteric fractures eligible for the study were treated with proximal femoral nail antirotation (PFNA) in our hospital. All patients were divided into two groups of 50 patients each: the TXA group and a blank control group. In the TXA group, all patients received TXA at a dose of 10 mg/kg-1 intravenously, 10 min preoperatively and 5 h postoperatively...
February 2, 2018: Injury
Li-Jun Zhu, Xiao-Fei Li, Chao Liu, Cheng-Yu Lyu
OBJECTIVE: To evaluate the clinical results of locking proximal femur plate(LPFP), proximal femoral nail antirotation(PFNA) and bipolar hemiarthroplasty(BPH) in the treatment of femoral intertrochanteric fractures in elderly patients. METHODS: Retrospective analysis of the 86 elderly patients with femoral intertrochanteric fractures during June 2011 and August 2016 were enrolled in this study. The patients were divided into 3 groups: 26 cases in LPFP group included 10 males and 16 females with an average age of (72...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jun Zhang, Lie-Hu Cao, Xiao Chen, Jia-Can Su
OBJECTIVE: To compare the clinical effects of PFNA and InterTAN for the treatment of unstable intertrochanteric fractures in the elderly patients. METHODS: From April 2012 to February 2014, 113 elderly patients with unstable intertrochanteric fractures were treated by PFNA or InterTAN. There were 64 cases in PFNA group, including 25 males and 39 females with an average age of (73.3±6.5) years old (ranged, 66 to 85);while 49 cases in InterTAN group, including 20 males and 29 females with an average age of (74...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hamidreza Yazdi, Ara Nazarian, John Y Kwon, Mary G Hochman, Reza Pakdaman, Poopak Hafezi, Morteza Ghahremani, Samad Joudi, Mohammad Ghorbanhoseini
BACKGROUND: The anatomical axis of the femur is crucial for determining the correct alignment in corrective osteotomies of the knee, total knee arthroplasty (TKA), and retrograde and antegrade femoral intramedullary nailing (IMN). The aim of this study was to propose the concept of different anatomical axes for the proximal and distal parts of the femur; compare these axes in normally aligned subjects and also to propose the clinical application of these axes. METHODS: In this cross-sectional study, the horizontal distances between the anatomical axis of the proximal and distal halves of the femur and the center of the intercondylar notch were measured in 100 normally aligned femurs using standard full length alignment view X-rays...
January 31, 2018: Journal of Orthopaedic Surgery and Research
Conglin Ye, Qi Lai, Shengtao Zhang, Tian Gao, Jin Zeng, Min Dai
RATIONALE: Osteopoikilosis is a rare and asymptomatic disease of the bone, which is often discovered occasionally on radiography for irrelevant complaints. Characterized by multiple, small, circular, or oval-shaped radiodense lesions, it may be confused with bony metastatic tumors. PATIENT CONCERNS: The present study describes a case of a 17-year-old adolescent who suffered from pain and movement limitation of his left thigh following a fall from standing height...
November 2017: Medicine (Baltimore)
Jin-Wei Xu, Lei Han, Yun-Gen Hu, Wei-Li Fang, Bo Ji
OBJECTIVE: To retrospectively study medium term follow-up outcomes of the femoral intertrochanteric with lateral femoral wall fractures using anatomic locking plate fixation. METHODS: From June 2010 to January 2013, 18 cases of the unstable femoral intertrochanteric with lateral femoral wall fractures were treated with the anatomic locking plate, included 8 males and 10 females with an average age of 75.5 years ranging from 19 to 83 years old. There were 8 cases of traffic accident injuries, 6 cases of falls injuries, and 4 cases of falling from high place...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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
Karthik Vishwanathan, Keyur Akbari, Amit J Patel
Introduction: The original Harris hip score (HHS) does not contain ability to perform squatting and sitting cross legged as items in the questionnaire and hence a need was felt to modify the Harris hip score so that it could stay relevant in functional assessment of Indian patients in the rural setting. Validity, responsiveness and ceiling floor effect of the Harris hip score after internal fixation of pertrochanteric fracture has not been previously described. The objective of the study was to investigate construct validity, responsiveness and ceiling floor effects of the modified Harris hip score (mHHS)...
March 2018: Journal of Orthopaedics
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
Mehmet Nuri Konya, Feza Korkusuz, Gokhan Maralcan, Teyfik Demir, Ahmet Aslan
Complication rates of hip fractures after proximal femoral nail are not rare. In such fractures, treatment invariably comprises the extraction of proximal femoral nail and the introduction of a different hip prosthesis. To solve this problem, we aimed to develop a new implant, the modular nail prosthesis, which combines an intramedullary nail with a hip prosthesis. The aim of this study was to determine the effect of stress load distribution on the stem using finite element analysis under laboratory conditions...
January 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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