scholarly journals Procedure for Femoral Intertrochanteric Fractures using the “Three‐Finger Method” Assisted by Proximal Femoral Nail Antirotation

2020 ◽  
Vol 12 (2) ◽  
pp. 543-551
Author(s):  
Qian Cheng, MD ◽  
Li Lin, BM ◽  
Xiao‐dong Zhu, MD ◽  
Gui‐zhu Li, MD ◽  
Xiao‐ming Gao, BM ◽  
...  
Keyword(s):  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation

scholarly journals Functional and Radiological Outcome of Unstable Intertrochanteric Fracture in Old Age Treated with Proximal Femoral Nail Antirotation-2

2021 ◽  
Author(s):  
OP Jamshad ◽  
Jacob Mathew ◽  
Raju Karuppal
Keyword(s):  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Biological Reduction ◽  
Neck Shaft Angle ◽  
Femoral Nail ◽  
Unstable Intertrochanteric Fracture ◽  
Shaft Angle ◽  
The Mean ◽  
Proximal Femoral Nail Antirotation

Introduction: Intertrochanteric fractures are prevalent in the elderly, which leave patients with functional restrictions. Proximal Femoral Nail Antirotation-2 (PFNA) was developed to achieve better fixation strength, particularly in the presence of osteoporotic unstable intertrochanteric fractures. Aim: To evaluate the role and result of PFNA-2 in the treatment of unstable intertrochanteric fractures in geriatric patients. Materials and Methods: A prospective analytical study was conducted in 35 patients with unstable intertrochanteric fractures. They were followed-up clinically and radiologically for one year. The quality of fixation was assessed, by neck-shaft angle and Tip Apex Distance (TAD). A functional assessment was done with the Harris Hip Score (HHS). Results: The mean follow-up period was 13 months (range, 12-14). The mean age of patients was 65.6 years and the majority were female patients (62.85%). Functional results according to modified HHS were found to be excellent in 6 (17.1%) patients, good in 14 (40%) patients, fair in 12 (34.3%) patients and poor in 3 (8.6%) patients. The average HHS in this study was 81.6. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16.0. Conclusion: PFNA-2 helps in achieving biological reduction and good stability which enables early mobilisation and prevention of excessive collapse. A good functional outcome could be achieved when the radiological parameters are restored, i.e., TAD <25 mm and neck-shaft angle difference <5° (compared to the opposite side).

scholarly journals Finite element analysis of two cephalomedullary nails in treatment of elderly reverse obliquity intertrochanteric fractures: zimmer natural nail and proximal femoral nail antirotation-ΙΙ

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jian Chen ◽  
Jian-xiong Ma ◽  
Ying Wang ◽  
Hao-hao Bai ◽  
Lei Sun ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Internal Fixation ◽  
Intertrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Element Analysis ◽  
Femoral Nail ◽  
Unstable Intertrochanteric Fracture ◽  
Proximal Femoral Nail Antirotation

Abstract Background More elderly patients are suffering from intertrochanteric fractures. However, the choice of internal fixation is still controversial, especially in the treatment of unstable intertrochanteric fracture; thus, previous implants continue to be improved, and new ones are being developed. The purpose of our study was to compare the biomechanical advantages between the zimmer natural nail (ZNN) and proximal femoral nail antirotation-II (PFNA-II) in the treatment of elderly reverse obliquity intertrochanteric fractures. Methods A three-dimensional finite element was applied for reverse obliquity intertrochanteric fracture models (AO31-A3.1) fixed with the ZNN or PFNA-II. The distribution, peak value and position of the von Mises stress and the displacement were the criteria for comparison between the two groups. Results The stresses of the internal fixation and femur in the ZNN model were smaller than those in the PFNA-II model, and the peak values of the two groups were 364.8 MPa and 171.8 MPa (ZNN) and 832.3 MPa and 1795.0 MPa (PFNA-II). The maximum amount of displacement of the two groups was similar, and their locations were the same, i.e., in the femoral head vertex (3.768 mm in the ZNN model and 3.713 mm in the PFNA-II model). Conclusions The displacement in the two models was similar, but the stresses in the implant and bone were reduced with the ZNN. Therefore, the ZNN implant may provide biomechanical advantages over PFNA-II in reverse obliquity intertrochanteric fractures, as shown through the finite element analysis. These findings from our study may provide a reference for the perioperative selection of internal fixations.

scholarly journals Hemiarthroplasty for the Management of unstable femoral intertrochanteric fractures in elderly patients over 75 years old: a retrospective matched comparative study

2020 ◽  
Author(s):  
Juncheng Ge ◽  
Jinhui Ma ◽  
Bailiang Wang ◽  
Yu Zhou ◽  
Debo Yue ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Intraoperative Blood Loss ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation ◽  
Partial Weight

Abstract Background To compare and analyze the therapeutic effect of Proximal Femoral Nail Antirotation and hemiarthroplasty on intertrochanteric fracture. Methods 45 patients with intertrochanteric fractures (17 males and 28 females) admitted to our hospital from January 2016 to January 2018 were collected. The mean age was 84.82 ± 0.73 years. All injuries were caused by falls during daily activities. Patients were divided into two groups according to the surgical method: the first group was the hemiarthroplasty group, referred to as the hemiarthroplasty group, with a total of 22 patients, and the average length of hospital stay was 13.09 ± 5.03 days. According to the improved Evans-Jensen classification [5], there were 1 cases of III, 9 cases of IV, and 12 cases of V12.The second group was the Proximal Femoral Nail Antirotation group, and the average length of hospital stay was 13.09 ± 6.97 days. According to the Evans-Jensen classification, 1 patient was III, 16 patients were IV, and 6 patients were V. Results Intraoperative blood loss was higher in the The Proximal Femoral Nail Antirotation group than in the hemiarthroplasty group(P=0.034).In the postoperative recovery of the two groups, the time from operation to partial weight-bearing of the hemiarthroplasty group was shorter than that of the PFNA group༈p༝0.000༉, and the postoperative HHS of the hemiarthroplasty group was also better than the latter (p ༝0.0005). In terms of total cost during hospitalization, the Hemiarthroplasty group was less than the PFN group(p ༝ 0.017). One year after surgery, the mortality rate increased to 34% in the PNFA group and 9% in the hemiarthroplasty group( P = 0.038), which was statistically significant. Conclusion Hemiarthroplasty for intertrochanteric fractures in the elderly can reduce intraoperative blood loss, achieve early recovery, improve survival rates, and reduce the economic burden on patients

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