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proximal femoral nail

István Flóris, Éva Belicza
INTRODUCTION: Proximal femoral fractures with severe outcome are most common in the increasing group of elderly patients. AIM: Based on the regular data gathered by the EuroHOPE research, the most important aspects and results of the treatment of proximal femoral fractures were studied. METHOD: Data of hospital admissions due to proximal femoral fractures were analyzed. RESULTS: There was a slight increase in the number of hospitalized patients between 2004 and 2009 in Hungary...
October 2016: Orvosi Hetilap
S Subramanian, M J Parker
Atypical femoral fractures have been associated with long term use of bisphosphonates. Our study plan was to report the outcome of treatment for a series of -patients with an atypical femoral fracture and to compare the characteristics of those patients with a proximal femoral fracture. 21 atypical fractures were identified over a seven year period and these were compared with those of 2.547 hip fracture patients treated over the same time period at a single centre. The mean age of patients with an atypical fracture was on average nine years less than that for the hip fracture patients (72 as against 81 years, p = 0...
August 2016: Acta Orthopaedica Belgica
S Hopp, R Wirbel, I Ojodu, A Pizanis, T Pohlemann, J Fleischer
The aim of this study was to compare two proximal femur nails with regard to the complication rate and midterm clinical outcome : the InterTAN nail (ITN) versus the third generation gamma nail (GN). 78 patients older than 60 years with an unstable intertrochanteric femoral fracture (AO/OTA 31 A2/A3) were randomised over a 20 month period into either ITN (n = 39) or GN (n = 39). The outcomes of interest were the perioperative implant-related complications and the functional status (Harris Hip Score) at 6 months postoperatively...
August 2016: Acta Orthopaedica Belgica
Young-Soo Byun, Gu-Hee Jung
PURPOSE: To verify the practical correlation between the topographical features of the femur neck base and the ideal entry point by analyzing three-dimensional (3D) models virtually implanted with an antegrade femoral nail. MATERIALS AND METHODS: A total of 103 cadaveric femurs (50 males and 53 females) were enrolled. Specimens underwent continuous 1.0mm slice computed tomography (CT) scans. CT images were rendered into 3D images using image-processing software (Mimics(®)) to reconstruct the geometry of the cortex and medullary canal...
September 12, 2016: Injury
N A Johnson, C Uzoigwe, M Venkatesan, V Burgula, A Kulkarni, J N Davison, R U Ashford
INTRODUCTION Intramedullary nailing is a common treatment for proximal femoral fractures. Fracture of the nail is a rare but devastating complication that exposes often frail patients to complex revision surgery. We investigated which risk factors predict nail failure. METHODS We reviewed all cases of nail breakage seen over a 10-year period in a single busy trauma unit; 22 nail fractures were seen in 19 patients. Comparison was made with a group of 209 consecutive patients who underwent intramedullary fixation of a proximal femur fracture with no nail breakage over a 2-year period...
September 23, 2016: Annals of the Royal College of Surgeons of England
Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Yoshihiko Okudera, Ken Sasaki, Tetsuya Kawano, Naohisa Miyakoshi, Yoichi Shimada
PURPOSE: In femoral trochanteric fractures, fractures whose fracture lines extend to the basal neck or to the subtrochanteric part have high instability. Area classification can identify such instable fractures. The best choices of internal fixators for femoral trochanteric fractures were investigated according to area classification. METHODS: Femoral trochanteric fractures were investigated with respect to area classification. In area classification, the proximal femur is divided into 4 areas with 3 boundary lines: Line-1 is the center of the neck; Line-2 is the border between the neck and the trochanteric zone; and Line-3 links the inferior borders of the greater and lesser trochanters...
2016: SpringerPlus
J Schmolders, S Koob, P Schepers, S Gravius, D C Wirtz, C Burger, P H Pennekamp, A C Strauss
Introduction/Background: With extended life expectancy, the number of primary joint arthroplasties has also increased. Revision surgery is also more often necessary, due to aseptic or septic loosening of the prosthesis or periprosthetic fracture. Large bone defects often occur in these patients and several non-modular, conventional implants are available to handle this difficult situation. Custom made implants offer an individually designed and defect-adapted shape with perfect covering of the lesion, but may delay the operation...
September 15, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
R Giancola, L P Marchesi, M G Lettera, G Antonini
We present the case of a 39-year-old sportswoman who was involved in a motorcycle accident in 2012. She sustained a complex proximal femoral fracture that involved the neck and trochanteric region. We decided to preserve the natural bone stock and repair the fractures, adopting skeletal traction in the first stage and then implanting an intramedullary nail. Twenty months later the fracture was healed clinically and radiologically and the patient was able to walk and run without pain.
September 6, 2016: Injury
Jae Hyuk Yang, Tae Gon Jung, Arjun Rupanagudi Honnurappa, Jae Min Cha, Chang Hwa Ham, Tae Yoon Kim, Seung Woo Suh
Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied...
2016: Applied Bionics and Biomechanics
Han Kook Yoon, Hyun Cheol Oh, Junyoung Park, Choidog Oyunbat, Taehwan Kim
Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling...
March 2016: Hip Pelvis
Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
PURPOSE: People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. MATERIALS AND METHODS: We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia...
September 2015: Hip Pelvis
Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
PURPOSE: To compare the clinical and radiological results between internal fixation using the proximal femoral nail system and bipolar hemiarthroplasty (BHA) in reverse oblique intertrochanteric hip fractures in elderly patients. MATERIALS AND METHODS: From January 2005 to July 2012, we reviewed the medical records of 53 patients who had been treated surgically for reverse oblique intertrochanteric fracture and had been followed-up on for a minimum of two years...
September 2015: Hip Pelvis
Jie Gu, Xin-yong Kang, Hong-wei Xu, Yong-fu Li, Bin Zahng, Jian Guo, Zhen-nian He
OBJECTIVE: To evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures. METHODS: Clinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
V Caiaffa, G Vicenti, C Mori, A Panella, V Conserva, G Corina, L Scialpi, A Abate, M Carrozzo, Leonardo Petrelli, G Picca, A Aloisi, G Rollo, M Filipponi, V Freda, A Pansini, A Puce, G Solarino, B Moretti
We investigated whether a proximal femoral nail can be implanted without a distal locking screw in AO/OTA 31-A1 and 31-A2 pertrochanteric stable femur fractures. A multicentre, randomised study was conducted in six level-two trauma centres in our area (Puglia, Italy). A total of 333 patients received their allocated intervention (162 in the locking group [LG] and 171 in the unlocking group [UG]) and 266 patients were included in the final analysis at 1year. Our data showed no statistically significant difference between the two groups at 1-year follow-up for ability to walk, SF-36 questionnaire results, residual pain (visual analogue scale [VAS] score) and level of overall satisfaction...
August 11, 2016: Injury
Pedro Luciano Teixeira Gomes, Luís Sá Castelo, António Lemos Lopes, Marta Maio, Adélia Miranda, António Marques Dias
Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented...
July 2016: Revista Brasileira de Ortopedia
Sampat S Dumbre Patil, Sachin S Karkamkar, Vaishali S Dumbre Patil, Shailesh S Patil, Abhijeet S Ranaware
BACKGROUND: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other...
July 2016: Indian Journal of Orthopaedics
Takeshi Utsunomiya, Takuaki Yamamoto, Goro Motomura, Kazuyuki Karasuyama, Kazuhiko Sonoda, Yusuke Kubo, Hiroyuki Hatanaka, Yukihide Iwamoto
INTRODUCTION: Transtrochanteric anterior rotational osteotomy of the femoral head (TRO) was developed as a joint preserving surgery for osteonecrosis of the femoral head. To the best of our knowledge, peri-implant fractures after femoral osteotomy have rarely been reported. PRESENTATION OF CASE: We report a 58-year-old female who suffered a peri-implant femoral shaft fracture following a fall from a stepladder eight years after TRO. Fracture union was achieved six months after a preferred proximal femoral locking plate...
2016: International Journal of Surgery Case Reports
Weiguang Yu, Xinchao Zhang, Rongbo Wu, Xingfei Zhu, Jun Hu, Yinfeng Xu, Jianhua Yi, Yunjiang Liu
BACKGROUND: The purpose of this study was to evaluate whether PFNA-II (Asia proximal femoral nail anti-rotation) and DHS (dynamic hip screw) carry substantial post-operative hidden blood loss and to compare PFNA-II with DHS in terms of post-operative hidden blood loss in elderly high-risk patients with intertrochanteric femur fractures(IFFs). METHODS: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively...
2016: BMC Musculoskeletal Disorders
Scott T Watson, Thomas M Schaller, Stephanie L Tanner, John David Adams, Kyle J Jeray
BACKGROUND: Basicervical peritrochanteric fractures are relatively rare, with 1.8% to 7.6% of hip fractures being identified as true basicervical fractures. The compression hip screw traditionally has been considered the "gold standard" for operative fixation of peritrochanteric fractures, with generally good results. The purpose of this study was to report the outcomes of basicervical peritrochanteric fractures of the proximal part of the femur treated with cephalomedullary nailing (CMN)...
July 6, 2016: Journal of Bone and Joint Surgery. American Volume
John A Disegi, Michael D Roach, Rod D McMillan, Brian T Shultzabarger
Management of femur fractures requires titanium alloy implants that provide a good combination of static strength and ductility plus sufficient high cycle fatigue strength to resist repetitive loading. A research program was initiated to determine whether aging treatments could increase the strength of alpha + beta Ti-15Mo while maintaining acceptable tensile ductility. A pilot heat treating study indicated the best combination of strength and ductility was obtained using an α + β annealing temperature of 705°C ± 10°C followed by an aging treatment of 482°C ± 10°C...
July 4, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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