“Screw First” Technique to Get Past Nail–Jig Mismatch in Proximal Femoral Nailing

Author(s):  
Atmananda S. Hegde ◽  
Prajwal P. Mane ◽  
Chethan B. Shetty ◽  
Samarth A. Thakkar
2021 ◽  
Vol 7 (3) ◽  
pp. 181-185
Author(s):  
Dr. BS Murthy ◽  
Dr. Ashish Sao ◽  
Dr. VA Senthil Kumar ◽  
Dr. Ravi Kant ◽  
Dr. Ozair Khan ◽  
...  

Author(s):  
Karthik Ramachandran ◽  
K. K. Arvind Manoj ◽  
A. Vishnu Sankar

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are one of the commonest fractures encountered in elderly population. Though there are various implants, proximal femoral nail has been the standard choice for management of unstable fractures. Inspite of its biomechanical advantages, various complications like screw cut out, Z effect, reverse Z effect does occur in proximal femoral nailing. The aim of the study is to analyse various factors determining the mechanical failures in patients operated with proximal femoral nail.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted in our institution from June 2014 to May 2018. The study included 72 patients with unstable intertrochanteric fractures treated with proximal femoral nail. All patients were followed for average period of 2 years. Functional outcome was assessed using Harris Hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the patients<strong> </strong>33%<strong> </strong>had excellent outcome. 42% had good and 14% had fair outcome. 11% of cases ended with poor outcome. Mechanical failure rate was less in patients with positive medial cortical support (PMCS) and in patients with tip apex distance difference between antirotation screw and lag screw (TAD<sub>AR </sub>-TAD<sub>LS</sub>) more than 15 mm. Whereas the difference in the position of lag screw centre had no significant influence in the mechanical failure rate in our study.</p><p class="abstract"><strong>Conclusions:</strong> From our study we like to conclude that the<strong> </strong>fracture reduction with positive medial cortical support and the TAD difference play a major role in determining the incidence of mechanical failure in proximal femoral nailing.</p>


2015 ◽  
Vol 4 (66) ◽  
pp. 11528-11534
Author(s):  
Venkateswara Rao D ◽  
Chinta Shyam Kumar ◽  
Anvesh Sangepu ◽  
Subramanyam Yadlapalli

2017 ◽  
Vol 25 (3) ◽  
pp. e37-e44 ◽  
Author(s):  
Mesut Mehmet Sonmez ◽  
Savas Camur ◽  
Erden Erturer ◽  
Meric Ugurlar ◽  
Adnan Kara ◽  
...  

Author(s):  
M. K. Nizamoddin Khateeb ◽  
Satish Babu D. G.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Incidence of intertrochanteric fractures has increased significantly during recent years and<strong> </strong>it will probably continue to rise in near future due to increased longevity of life. Closed methods of treatment for intertrochanteric fractures have increased mortality rates &amp; have largely been abandoned. Rigid internal fixation and early mobilization has been the standard protocol of treatment nowadays. This study was intended to compare the results of Intertrochanteric fractures treated by dynamic hip screw (DHS) over proximal femoral nailing (PFN)</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a randomized prospective study of 102 cases of intertrochanteric fractures,<strong> </strong>admitted to Mysore Medical College &amp; Hospital, Mysore and ESIC medical college and hospital Kalaburagi and Kamareddy Ortho &amp; Trauma care Hospital Kalaburagi; treated with proximal femoral nailing and DHS. The patients were divided randomly into two groups, each of 51 patients, 51 were treated by Dynamic Hip Screw &amp; 51 were treated with proximal femoral nail (PFN).All patients were followed up for one year</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our series of 102 patients of Intertrochanteric fractures, 51 were treated with sliding hip screw with<strong> </strong>plate and 51 were treated by an intra-medullary hip screw. Most of the patients were between 51 to 80 years. Slip and trivial fall accounted for 70% cases. Right side was more common accounted for 58.34% of cases</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">From our study, we consider PFN as better alternative to DHS in more unstable fractures with technically difficulty and require more experience. Sliding hip screw remains the implant of choice for stable type fractures. We noticed less operative time, less blood loss, fewer intra-op complications in PFN group. The quality of the reduction achieved &amp; proper positioning of the implant are important to achieve the best post-operative outcome</span><span lang="EN-IN">.</span></p>


Sign in / Sign up

Export Citation Format

Share Document