P04 Is the tip apex distance a predictor of failure in intertrochanteric hip fractures treated with proximal femoral nail?

Injury ◽  
2016 ◽  
Vol 47 ◽  
pp. S26
Author(s):  
K. Kayaokay ◽  
N. Ozkayin ◽  
M.C. Sozbilen ◽  
B. Ozcanyuz ◽  
J. Mirzazade ◽  
...  
Keyword(s):  
Hip Fractures ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Tip Apex Distance

scholarly journals Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old

2020 ◽  
Vol 11 ◽  
pp. 215145932093644
Author(s):  
Tomohiro Matsumura ◽  
Tsuneari Takahashi ◽  
Mitsuharu Nakashima ◽  
Yoshiya Nibe ◽  
Katsushi Takeshita
Keyword(s):  
Blood Loss ◽  
Internal Fixation ◽  
Clinical Outcomes ◽  
Hip Fractures ◽  
Preliminary Investigation ◽  
Japanese Patients ◽  
Proximal Femoral Nail ◽  
Surgical Time ◽  
Japanese Cohort ◽  
Femoral Nail

Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Materials and Methods: This study involved a retrospective analysis of data on trochanteric hip fracture patients who had undergone internal fixation from March 2016 to June 2018. The inclusion criteria were patients >70 years old with trochanteric hip fractures who could walk independently before the injury and were followed up for ≥3 months after surgery. Initially, 124 patients were identified, but 33 of these were excluded because other implants were used for internal fixation. Of the remaining 91 patients in whom PFNs were used at the time of internal fixation who were included for the perioperative evaluation, 66 patients followed up for ≥3 months were included in the clinical evaluations. Results: The average surgical time was 56.8 ± 19.6 minutes (range, 23-123 minutes). The average blood loss was 89 ± 41 mL (range, 0-245 mL). The union rate was 98%. Discussion: There were no cases of nail jamming, and all nails were successfully inserted below the end of the distal isthmus without additional reaming to dilate the canal. Conclusions: Proximal femoral nails were a useful implant in Japanese elderly patients with trochanteric hip fractures and gave comparable clinical outcomes despite the femoral length being short and occurrence of intensive bowing.

scholarly journals Proximal Femoral Nail Antirotation in Treatment of Intertrochanteric Hip Fractures: a Retrospective Study in 113 Patients

2015 ◽  
Vol 69 (6) ◽  
pp. 352 ◽  
Author(s):  
Sahmir Sadic ◽  
Svemir Custovic ◽  
Mahir Jasarevuc ◽  
Mirsad Fazlic ◽  
Ferid Krupic
Keyword(s):  
Retrospective Study ◽  
Hip Fractures ◽  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation

Rewriting the tip apex distance for the proximal femoral nail anti-rotation

Injury ◽  
2017 ◽  
Vol 48 (8) ◽  
pp. 1843-1847 ◽  
Author(s):  
Michael Yam ◽  
Anuj Chawla ◽  
Ernest Kwek
Keyword(s):  
Proximal Femoral Nail ◽  
Femoral Nail ◽  
Tip Apex Distance

scholarly journals The Results of Unstable Intertrochanteric Femur Fracture Treated with Proximal Femoral Nail Antirotation-2 with respect to Different Greater Trochanteric Entry Points

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sharan Mallya ◽  
Surendra U. Kamath ◽  
Rajendra Annappa ◽  
Nithin Elliot Nazareth ◽  
Krithika Kamath ◽  
...  
Keyword(s):  
Entry Point ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Care Hospital ◽  
Femoral Nail ◽  
Tip Apex Distance ◽  
Proximal Femoral Nail Antirotation ◽  
Modified Harris Hip Score

Background. Proximal femoral nail antirotation-2 (PFNA-2) has been widely used to treat intertrochanteric fractures with varied outcomes in the previous studies. The entry point of the nail plays an important role in achieving acceptable reduction, stable fixation, and avoiding implant related complications. This study was proposed to determine the optimal greater trochanteric entry point for PFNA-2 in unstable intertrochanteric femur fractures. Methods. We conducted an observational study on 40 patients with unstable intertrochanteric fracture treated with PFNA-2 implant in a tertiary care hospital. The patients were grouped into two based on the entry point: group L for lateral and group M for medial entry. Randomization was carried out by assigning the patients to the group by alternate allocation. The quality of reduction, tip apex distance, Cleveland index, and all the complications were noted. The final follow-up was conducted at six months. The functional outcome was evaluated using modified Harris hip score. The data analysis was performed using Student’s t-test, chi square test, and Mann–Whitney test. A P value below 0.05 was considered significant. Results. Forty patients with 20 patients treated with medial entry point were included in group M and 20 patients in group L with lateral entry point. The group L had an average tip apex distance of 20.53 and group M had 20.02 (P=0.8). The complication of screw back out was seen in 3 out of 4 patients with poor reduction in group L. As per the Cleveland index, 6 patients in each group had suboptimal position and 4 out of 6 patients in group L with suboptimal position had screw back out. The lateral cortex impingement was seen in 14 patients of group L and 6 patients in group M with significant comparison (P=0.01). Three patients in group L had varus collapse with screw back out. Also, none in group M (0.05). The average modified Harris hip score in group L at six months follow-up was 71.94 and 76.8 in group M (P=0.84). Conclusion. Overall, to achieve good quality of fixation and reducing damage to gluteus medius entry point for PFNA-2 should be 5 mm medial to the greater trochanter tip.

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