Peritrochanteric Fractures of the Femur: A Comparison between the Ender Nail, Gamma Nail and Dynamic Hip Screw

1996 ◽  
Vol 6 (1) ◽  
pp. 29-39 ◽  
Author(s):  
J.A. De Pedro ◽  
J. Rey ◽  
R. Lopez-Casero ◽  
A.J. Perez-Cab Aller ◽  
I Dominguez ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Operation Time ◽  
Clinical Results ◽  
Gamma Nail ◽  
Dynamic Hip Screw ◽  
Bony Union ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Fracture Configuration ◽  
Hip Screw

Surgical fixation, early weight-bearing, and bony union remain a challenge in the treatment of peritrochanteric femur fractures, especially if the fractures are comminuted or unstable. A randomized prospective study of 154 fractures treated by either the Gamma nail (43), Dynamic Hip Screw (DHS) (30) or Ender's nail (81) is reported. The average follow-up for Ender's nails was 36.7 months; for DHS 39.4 months and for Gamma nails 37.3 months. The Ender's nails required a significantly (p<0.001) shorter operation time of 42±13.4 min. The Gamma nail group required a higher mean duration of screening, 193±92 sec. Few screws in either group were in a bad position, but 12 (32%), in the Gamma nail group, and 2 (10%) in the DHS were placed superiorly in the head. From this experience, the Gamma nail appears to allow for early patient ambulation regardless of the fracture configuration with good clinical results, but the potential advantages of the Gamma nail are still unclear in these already compromised patients.

scholarly journals Dynamic Hip Screw with Trochanter-Stabilizing Plate Compared with Proximal Femoral Nail Antirotation as a Treatment for Unstable AO/OTA 31-A2 and 31-A3 Intertrochanteric Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Chun-Wei Fu ◽  
Ji-Ying Chen ◽  
Yueh-Ching Liu ◽  
Kuang-Wen Liao ◽  
Yung-Chang Lu
Keyword(s):  
Intertrochanteric Fracture ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Residual Pain ◽  
Unstable Intertrochanteric Fracture ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation ◽  
Im Nailing

Background. The dynamic hip screw (DHS) with the addition of an angular stable trochanter-stabilizing plate (TSP) has been considered the ideal treatment for the unstable intertrochanteric fracture type. However, there have been few comparisons between DHS+TSP augmentation with intramedullary (IM) nailing. The aim of this retrospectively registered study was to compare the clinical outcomes of patients with the unstable type of intertrochanteric fractures treated with DHS+TSP or IM nailing (proximal femoral nail antirotation (PFNA)). Methods. From June 2013 to April 2018, 358 patients with proximal femur fracture AO/OTA type 31A2 and 31A3 treated with PFNA or DHS+TSP and followed for ≥10 months postoperatively were included. The surgical-dependent outcome evaluation included the operation time, intraoperative blood loss, postoperative decrease in hemoglobin, and blood transfusion amount. Functional status was also measured. Radiographic findings and postoperative complications were recorded and analyzed. Result. The operation time was significantly shorter in the DHS+TSP group than that in the PFNA group for both A2 and A3 fractures (A2 type: 84.0 vs.96.4 min; p<0.05; A3 type: 102.4 vs.116.1 min; p<0.05). Postoperative decrease in hemoglobin was more significant in the PFNA group than that in the DHS+TSP group for both fracture types (A2 type: −1.88 vs. −1.29 (mg/dL); p<0.05; A3 type: −1.63 vs. −1.04 (mg/dL); p<0.05). However, the patients treated with DHS+TSP had significantly more residual pain than those treated with PFNA during the final follow-up (Visual Analog Scale score, A2 type: 28.4 vs.23.2; p<0.05; A3 type: 27.5 vs.23.6; p<0.05) and complained of greater implant irritation. Conclusion. We found that DHS+TSP was associated with less operation time and less postoperative decrease in hemoglobin but more residual pain and implant irritation than those of PFNA. As a treatment for unstable intertrochanteric fracture, DHS+TSP provided ideal surgical outcomes which were not inferior to the PFNA.

Invited commentary to: "Gamma nail vs. dynamic hip screw in 120 elderly patients — A randomized trial"

1997 ◽  
Vol 29 (5) ◽  
pp. 294-295 ◽  
Author(s):  
F. J. Seibert ◽  
G. Schippinger ◽  
R. Szyszkowitz
Keyword(s):  
Elderly Patients ◽  
Randomized Trial ◽  
Gamma Nail ◽  
Dynamic Hip Screw ◽  
Hip Screw

Surgical Treatment of Distal Femur Fractures using LISS System

2003 ◽  
Vol 10 (3) ◽  
pp. 36-42
Author(s):  
D Cherkes-Zade ◽  
M Monesi ◽  
A Causero ◽  
M Marcolini ◽  
D Cherkes-Zade ◽  
...  
Keyword(s):  
New Technology ◽  
Weight Bearing ◽  
Long Bone ◽  
Operative Trauma ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Bone Fragments ◽  
Total Knee ◽  
Using Data

Osteosynthesis with LISS system (less invasive stabilization system) is a new technology and this conception of stabilization of long bone fragments is a new step in the development of AO philosophy. Indications to application of this system are distal metaepiphysis and diaphysis femur fractures, supra- and transcondylar fractures in polytrauma, fractures in osteoporosis as well as fractures after total knee replacement. During the last 3 years 35 patients were operated on by that technique. The follow-up period ranged from 6 months to 3 years. Assessment of outcomes was performed using data of clinical examination and evaluation of radiograms with modified Neer-Grantham-Shelton scale. In patients who were operated on I year ago the total score varied from 70 to 80 (maximum - 100). Advantages of this technology as compared to the traditional methods of osteosynthesis are the following: limited operative trauma, less blood loss, shortening of surgery duration, preservation of tissue physiology as well as absence of the necessity to use cement and bone auto- and allografts. Disadvantages include the difficulty for reposition prior to fixation and impossibility of correction in postoperative period as well as early weight-bearing load.

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