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proximal femoral nail

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https://www.readbyqxmd.com/read/29780829/the-effect-of-c-arm-mobility-and-field-of-vision-on-radiation-exposure-in-the-treatment-of-proximal-femoral-fractures-a-randomized-clinical-trial
#1
Mahmut Kalem, Kerem Başarır, Hakan Kocaoğlu, Ercan Şahin, Hakan Kınık
Objectives: To examine the effect of fluoroscopy devices with different sizes of image intensifier and C-arm maneuverability on operating time, fluoroscopy time, radiation dose and reduction, and fixation quality at intertrochanteric femoral fractures. Design: Single-center, randomized, prospective study. Setting: Academic Level I trauma hospital. Patients and Intervention: 34 patients treated with cephalomedullary nailing for a stable, intertrochanteric proximal femur fracture (OTA A1)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29724590/cement-augmentation-of-the-proximal-femoral-nail-antirotation-pfna-a-multicentre-randomized-controlled-trial
#2
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
#3
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/29720212/individualized-approach-to-the-surgical-management-of-fibrous-dysplasia-of-the-proximal-femur
#4
Bas C J Majoor, Andreas Leithner, Michiel A J van de Sande, Natasha M Appelman-Dijkstra, Neveen A T Hamdy, P D Sander Dijkstra
BACKGROUND: Fibrous dysplasia of the proximal femur presents with heterogeneous clinical manifestations dictating different surgical approaches. However, to date there are no clear recommendations to guide the choice of surgical approach and no general guidelines for the optimal orthopedic management of these lesions. The objective of this study was to evaluate treatment outcomes of angled blade plates and intramedullary nails, using as outcome indicators revision-free survival, pain, function and femoral neck-shaft-angle...
May 2, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29701097/-rail-and-nail-bifocal-management-of-atrophic-femoral-nonunion
#5
K Davda, N Heidari, P Calder, D Goodier
Aims The management of a significant bony defect following excision of a diaphyseal atrophic femoral nonunion remains a challenge. We present the outcomes using a combined technique of acute femoral shortening, stabilized with a long retrograde intramedullary nail, accompanied by bifocal osteotomy compression and distraction osteogenesis with a temporary monolateral fixator. Patients and Methods Eight men and two women underwent the 'rail and nail' technique between 2008 and 2016. Proximal locking of the nail and removal of the external fixator was undertaken once the length of the femur had been restored and prior to full consolidation of the regenerate...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29668448/tranexamic-acid-in-pertrochanteric-femoral-fracture-is-it-a-safe-drug-or-not
#6
Andrea Schiavone, Michele Bisaccia, Ivan Inkov, Giuseppe Rinonapoli, Mattia Manni, Giuseppe Rollo, Luigi Meccariello, Cristina Ibáñez Vicente, Paolo Ceccarini, Carmelinda Ruggiero, Auro Caraffa
BACKGROUND: There is a high incidence of blood transfusion following hip fractures in elderly patients. AIM: The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery. MATERIALS AND METHODS: Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45)...
March 1, 2018: Folia Medica
https://www.readbyqxmd.com/read/29657465/do-demographic-and-perioperative-parameters-really-affect-the-final-outcomes-of-pediatric-femur-shaft-fractures-managed-by-elastic-nails-a-prospective-study
#7
Abhinandhan Reddy, Narendran Pushpasekaran, Jitendra Singh, Gokul Chand Verma, Sathyamurthy Palanisamy
Objective: Pediatric femoral shaft fractures are more commonly treated with intramedullary titanium elastic nail system (TENS). Adhering to the principles, most studies had supported excellent results with this instrumentation and attributed the variation in age, weight, immobilization protocols, technical factors like fracture pattern, reduction and complications as reasons to poor outcomes in their individual studies. Hence, we wanted to identify the potential demographic and perioperative parameters that could affect the final outcomes in this cohort...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29649099/functional-and-radiological-results-of-proximal-femoral-nail-antirotation-pfna-osteosynthesis-in-the-treatment-of-unstable-pertrochanteric-fractures
#8
Ahmad M Radaideh, Hashem A Qudah, Ziad A Audat, Rami A Jahmani, Ibraheem R Yousef, Abed Allah A Saleh
Pertrochanteric femur fractures are considered amongst the most commonly encountered fractures in the geriatric age group. We evaluated radiographic and functional outcomes of patients with unstable pertrochanteric fractures treated with the proximal femur nail antirotation (PFNA). Between March 2013 and December 2015, fifty patients (28 male and 22 females with a mean age of 72.8 years (range, 20-94)) with unstable pertrochanteric fractures (AO 31.A2 and 31.A3) were fixed with the PFNA at our institution, and they were retrospectively evaluated...
April 12, 2018: Journal of Clinical Medicine
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/29564297/treatment-of-proximal-femur-osteomyelitis-occurred-after-proximal-femoral-nail-antirotation-fixation-with-antibiotic-cement-coated-tibia-intramedullary-nail-a-case-report
#10
Jong Ho Noh, Sung Jun Koh, Kee Haeng Lee
Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively...
March 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29543057/the-use-of-a-femoral-distractor-in-the-presence-of-an-intramedullary-nail-proximal-to-an-osteoporotic-fracture
#11
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
https://www.readbyqxmd.com/read/29517952/optimizing-stability-in-ao-ota-31-a2-intertrochanteric-fracture-fixation-in-older-patients-with-osteoporosis
#12
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...
May 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29515648/analysis-of-the-impact-of-configuration-of-the-stabilisation-system-for-femoral-diaphyseal-fractures-on-the-state-of-stresses-and-displacements
#13
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
https://www.readbyqxmd.com/read/29499715/comparison-of-a-twin-interlocking-derotation-and-compression-screw-cephalomedullary-nail-intertan-with-a-single-screw-derotation-cephalomedullary-nail-proximal-femoral-nail-antirotation-a-systematic-review-and-meta-analysis-for-intertrochanteric-fractures
#14
REVIEW
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
https://www.readbyqxmd.com/read/29480890/is-total-femur-replacement-a-reliable-treatment-option-for-patients-with-metastatic-carcinoma-of-the-femur
#15
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...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29459684/clinical-analysis-of-peri-operative-hidden-blood-loss-of-elderly-patients-with-intertrochanteric-fractures-treated-by-unreamed-proximal-femoral-nail-anti-rotation
#16
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
https://www.readbyqxmd.com/read/29457413/-clinical-observation-of-proximal-femoral-anti-rotation-nail-for-the-treatment-of-femoral-intertrochanteric-fracture
#17
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
https://www.readbyqxmd.com/read/29430494/elastic-stable-intramedullary-nailing-of-femoral-shaft-fracture-experience-in-48-children
#18
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
https://www.readbyqxmd.com/read/29429246/-comparative-study-of-proximal-femoral-nail-anti-rotation-and-dynamic-hip-screw-in-the-unstable-intertrochanteric-fractures-in-the-elderly
#19
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]
https://www.readbyqxmd.com/read/29428222/cost-utility-analysis-in-orthopaedic-trauma-what-pays-a-systematic-review
#20
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...
March 2018: Injury
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