scholarly journals Femoral trochanteric fracture: PFNA spiral blade placement with the aid of an angler

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051989078
Author(s):  
Ye Yu ◽  
Keliang Pan ◽  
Gangxiang Wang
Keyword(s):  
Internal Fixation ◽  
Intramedullary Nailing ◽  
Group Versus ◽  
Trochanteric Fracture ◽  
Fixation Failure ◽  
Surgery Group ◽  
Bleeding Volume ◽  
Hip Function ◽  
Surgical Bleeding ◽  
Spiral Blade

Objective To investigate the effect of angler-assisted proximal femoral nail antirotation (PFNA) spiral blade fixation in treating femoral trochanteric fractures. Methods Patients who underwent angler-assisted PFNA screw blade fixation (angler-assisted group), or conventional internal fixation-intramedullary nailing (traditional surgery group) were included. Intraoperative indicators and treatment effects data were retrospectively analysed. Results Statistically significant differences were observed between the angler-assisted group ( n = 27) and traditional surgery group ( n = 28) regarding surgery duration (71.24 ± 8.01 min versus 81.50 ± 11.56 min), number of intraoperative fluoroscopy images (7.28 ± 0.91 versus 12.83 ± 1.55), and surgical bleeding volume (88.80 ± 7.98 ml versus 121.11 ± 27.21 ml). Rates of one-time intramedullary pin puncture for internal fixation in the angler-assisted and traditional surgery groups were 92.59% (25/27) and 32.14% (9/28), respectively. At 1 year following surgery, fractures in both groups had healed without internal fixation failure or fracture displacement failure. Harris hip function scores were 90.68 ± 4.23 (angler-assisted group) versus 81.69 ± 5.85 (traditional surgery group). Conclusions Angler-assisted intramedullary nailing with PFNA spiral blade provides good spiral blade positioning, low internal fixation failure rate, low fluoroscopy, short surgery time, and low bleeding volume. Hip function was well restored.

scholarly journals Pitfalls and Remedial Technique of Intramedullary Nail for Subtrochanteric Femur Fractures: A Case Series

2021 ◽  
Author(s):  
Botao Chen ◽  
Xiaohong Fan
Keyword(s):  
Internal Fixation ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Locking Plate ◽  
Case Series ◽  
Trochanteric Fracture ◽  
Subtrochanteric Fracture ◽  
Chinese Patients ◽  
Good Reduction ◽  
Subtrochanteric Fractures

Abstract Background: Intraoperative technical complications are occasionally encountered while implanting intramedullary nails for subtrochanteric fractures. Surgeons must pay attention to the pitfalls and remedial technique of this operation.Methods: We report on three cases in which intraoperative difficulties occurred during the implantation of an intramedullary nail among Han Chinese patients from mainland China. In Case 1, during an operation on a 57-year-old man, a seinsheimer type V in a right subtrochanteric fracture was not fully realized, and the dislocation of intertrochanteric fracture was aggravated after reduction of the subtrochanteric fracture. The intramedullary nail fixation was completed with the aid of an additional anterolateral plate. Case 2 involved a transverse subtrochanteric fracture. The surgeon neglected the coronal dislocation when considering good sagittal reduction. Although an auxiliary reduction device was used during the operation, there was unacceptable coronal dislocation after the intramedullary nail was inserted. A temporary anterolateral locking plate fixation was used to complete the intramedullary nail fixation. Case 3 involved an old trochanteric fracture combined with a new subtrochanteric fracture in an 81-year-old woman. After reducing the subtrochanteric fractures, the intramedullary nail fixation was successfully completed by releasing the poorly healed intertrochanteric fractures and fixing the anterior lateral plate.Results: With the development of techniques, reliable results can be obtained with fewer complications. Of the various internal fixation methods, we favor using a trochanteric start intramedullary nail.Conclusions: The treatment of subtrochanteric fractures presents challenges. Good reduction and reliable temporary fixation are key to completing the intramedullary nailing. If percutaneous joysticks, finger reduction tools, blocking screws, clamps, and Schanz pins cannot be used for effective auxiliary reduction or temporary reliable fixation, reduction after intramedullary nailing will not be satisfactory. The temporary addition of a reconstruction locking plate can achieve good reduction and temporary stability, and an extra reconstruction locking plate should be retained when the temporary fixation device is removed to reduce the risk of internal fixation failure during fracture healing.

scholarly journals Surgical Treatment of Internal Fixation Failure of Femoral Peritrochanteric Fracture

2021 ◽  
Author(s):  
Gang Zhong ◽  
Lin Teng ◽  
Hai‐bo Li ◽  
Fu‐guo Huang ◽  
Zhou Xiang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Fixation Failure

scholarly journals Treatment of Intertrochanteric Femur Fractures with Hip Arthroplasty in Older Patients: A Narrative Review of Indications and Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 763
Author(s):  
Tiago Martinho ◽  
Karl Stoffel
Keyword(s):  
High Risk ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Bipolar Hemiarthroplasty ◽  
Intramedullary Nails ◽  
Fixation Failure ◽  
Femur Fractures

Intertrochanteric femur fractures are common in older patients and often have a significant impact on disability. The treatment aims to achieve a rapid return to the prior functional level with a low rate of complications and mortality. Surgical management by internal fixation is the mainstay of treatment for most of these fractures. Even when treated with intramedullary nails, the overall complication rates are high, especially for unstable or highly comminuted fractures or in the presence of poor bone quality. Hip arthroplasty is an alternative in older patients with intertrochanteric femur fractures at high risk of fixation failure or with concomitant intraarticular pathologies. Especially patients whose condition precludes prolonged bedrest and who are at risk of significant deterioration if their locomotor function cannot be restored rapidly are likely to benefit from hip arthroplasty. The choice of the surgical technique mainly depends on the surgeon’s preferences and the fracture characteristics. Bipolar hemiarthroplasty is the most common type of prosthesis used with primary or revision femoral stems. Compared with intramedullary nails, hip arthroplasty has a better early functional outcome and lower rates of surgical complications as well as reoperations. However, the functional outcome and the mortality rate in the longer term tend to favor intramedullary nails, even though the results are inconsistent, and a statistically significant difference cannot always be obtained. Currently, there are no guidelines that define the role of hip arthroplasty in the treatment of intertrochanteric femur fractures in older patients. The literature only offers an overview of the possibilities of the usage of hip arthroplasty, but methodological limitations are common, and evidence levels are low. Further studies are needed to identify the intertrochanteric fractures that are at high risk of internal fixation failure, the characteristics that determine which patients may benefit most from hip arthroplasty, and the optimal surgical technique.

A Biomechanical Evaluation of Three Forms of Internal Fixation Used in Ankle Arthrodesis

1994 ◽  
Vol 15 (6) ◽  
pp. 297-300 ◽  
Author(s):  
Michael P. Dohm ◽  
James B. Benjamin ◽  
Jeffrey Harrison ◽  
John A. Szivek
Keyword(s):  
Internal Fixation ◽  
Plate Fixation ◽  
Ankle Arthrodesis ◽  
Biomechanical Study ◽  
The Other ◽  
Fixation Failure ◽  
Plate Group ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
Fibular Strut

A biomechanical study was undertaken to evaluate the relative stability of three types of internal fixation used for ankle arthrodesis. Crossed screw fixation, RAF fibular strut fixation, and T-plate fixation were tested in 30 cadaver ankles using an MTS machine. T-plate fixation consistantly provided the stiffest construct when compared with the other types of fixation. Failure occurred by distraction of bony surfaces, posterior to the plane of fixation, in the crossed screw and RAF groups. In contrast, failure in the T-plate group occurred through compression of bone anterior to the midcoronal plane of the tibia. Although the stability of fixation is only one factor in determining the success or failure of ankle arthrodesis, the results of this study would support T-plate fixation over the other forms tested.

scholarly journals Failure of Internal Fixation of The Anterior Ring For Unstable Pelvic Fractures, The Experience of A Single Institute

2021 ◽  
Author(s):  
Sheng Zhang ◽  
Huagui Mo ◽  
Yucheng Liu ◽  
Guohua Zhu ◽  
Bin Yu
Keyword(s):  
Internal Fixation ◽  
Pelvic Ring ◽  
Treatment Strategies ◽  
Pubic Symphysis ◽  
Pelvic Fractures ◽  
Fixation Failure ◽  
Initial Surgery ◽  
Multidisciplinary Cooperation ◽  
Preoperative Plan ◽  
Anterior Ring

Abstract Background: This study aimed to share our experience of anterior ring fixation failure for unstable pelvic fractures and propose corresponding treatment strategies. Materials: From January 2009 to December 2018, 93 patients with pelvic fractures were retrospectively reviewed. Patients with failure of the anterior ring internal fixation within 3 months after initial surgery were analyzed. Quality of reduction was evaluated using the Majeed scoring system.Results: According to the Tile classification of fracture, there were 23 cases of type B1, 17 cases of type B2, 11 cases of type B3, 28 cases of type C1, 6 cases of type C2, and 8 cases of type C3. The duration from injury to pelvic internal fixation ranged from 5-28 days. Seven out of 93 patients experienced failure of internal fixation of the anterior pelvic ring within 3 months, including 2 patients fixed with an external fixator and 5 patients were fixed with a plate. Five patients undergoing revision surgery were followed up for 6-36 months with an average of 18 months. According to Majeedscore at the last follow-up, there were 2 cases of excellent, 2 cases of good, 1 case of fair, and the excellent and good rate reached 80%.Conclusion: The treatment of complicated unstable pelvic fractures requires early multidisciplinary cooperation, proper management of hemodynamic stability and other comorbidities, and performing internal fixation surgery within 2 weeks. It is necessary to make a preoperative plan and stabilize the posterior ring first, avoiding a single steel plate crossing the pubic symphysis.

scholarly journals PFNA-II Internal Fixation Helps Hip Joint Recovery and Improves Quality of Life of Patients with Lateral-Wall Dangerous Type of Intertrochanteric Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Weilu Mu ◽  
Junlin Zhou
Keyword(s):  
Internal Fixation ◽  
Hip Joint ◽  
Intertrochanteric Fracture ◽  
Operation Time ◽  
Lateral Wall ◽  
Intraoperative Blood Loss ◽  
Function Score ◽  
Curative Effect ◽  
Hip Function

Objective. To analyze the effect of PFNA-II internal fixation on hip joint recovery and quality of life (QOL) in patients with lateral-wall dangerous type of intertrochanteric fracture. Methods. One hundred and twelve patients with lateral-wall dangerous type of intertrochanteric fracture who underwent surgical treatment in our hospital from May 2017 to May 2019 were selected as the participants of the study. Based on the treatment method, all the enrolled patients were divided into two groups: proximal femoral nail antirotation (PFNA group; n = 59 ) who received closed reduction and minimally invasive PFNA internal fixation and dynamic hip screw group (DHS; n = 53 ) who received internal fixation. The clinical indicators, curative effect, hip function score, pain degree, postoperative QOL score, and complications were compared between the two groups. Results. The operation time, intraoperative blood loss, postoperative drainage volume, and the incidence of postoperative complications in PFNA group were statistically lower than those in DHS group ( P < 0.05 ). The curative effect in PFNA group was notably better than that in DHS group. There were no significant differences in scores of hip function, visual analogue scale (VAS), and QOL between the two groups before operation ( P > 0.05 ). However, the hip function score and QOL score increased in both groups after surgery, and the increase was more significant in the PFNA group, while the VAS score decreased in both groups, and the decrease in PFNA group was more significant ( P < 0.05 ). Conclusion. PFNA internal fixation for the treatment of lateral-wall dangerous type of intertrochanteric fracture has the advantages of short operation time, less intraoperative blood loss, effective improvement of hip joint function, and fewer postoperative complications, which is worthy of clinical application.

scholarly journals Hip function and health-related quality of life in intramedullary and extramedullary internal fixation of trochanteric fractures

2020 ◽  
Vol 148 (7-8) ◽  
pp. 451-454
Author(s):  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Igor Kostic ◽  
Predrag Stojiljkovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Internal Fixation ◽  
Harris Hip Score ◽  
Health Related Quality ◽  
Trochanteric Fractures ◽  
Component Score ◽  
Related Quality ◽  
Health Related ◽  
Hip Function

Introduction/Objective. There are extramedullary and intramedullary methods of trochanteric fractures? internal fixation with implants having a lag screw. The objective of this study was to examine the difference in impact of these fixation types on final hip function and health-related quality of life. Method. There were 75 patients treated for a trochanteric fracture, using self-dynamisable internal fixator (SIF group), as an extramedullary method, or gamma nail (GN group), as an intramedullary method. These patients were called for the evaluation of Harris Hip Score (HHS) and SF-12 questionnaire at least two years after surgery. The SF-12 questionnaire has dual expression ? physical component score (PCS) and mental component score (MCS). Results. There were no significant differences between the SIF group and the GN group regarding HHS, PCS, and MCS. Positive correlation was confirmed between HHS, PCS, and MCS, with the strongest relation between HHS and PCS. Negative correlation was confirmed between age and HHS. Conclusion. There was no difference in final hip function and health-related quality of life between SIF and GN methods in trochanteric fractures treatment (p > 0.05). These parameters of outcome were confirmed to have positive interrelation (p < 0.05). Both submuscular presence of extramedullary implant with dimensions of SIF and the need for bone reaming in cephalomedullary fixation were considered not to have significant impact in HHS and SF-12 scores after trochanteric fractures treatment by internal fixation.

scholarly journals Internal fixation of trochanteric fracture following hip resurfacing

Injury Extra ◽  
2011 ◽  
Vol 42 (11) ◽  
pp. 183-185 ◽  
Author(s):  
Gwithyen Silk ◽  
Marshall Sangster ◽  
Harvinder Sandhu
Keyword(s):  
Internal Fixation ◽  
Trochanteric Fracture ◽  
Hip Resurfacing
Sign in / Sign up

Export Citation Format

Share Document