scholarly journals Treatment of Trochanteric Fractures with Proximal Femoral Nail Antirotation or Dynamic Hip Screw Systems: A Meta-Analysis

2012 ◽  
Vol 40 (3) ◽  
pp. 839-851 ◽  
Author(s):  
C Zeng ◽  
Y-R Wang ◽  
J Wei ◽  
S-G Gao ◽  
F-J Zhang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Meta Analysis ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intraoperative Blood Loss ◽  
Trochanteric Fractures ◽  
Fixation Failure ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation

OBJECTIVE: A meta-analysis to compare the intraoperative and postoperative outcome data for the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) implant systems for the treatment of patients with trochanteric fractures. METHODS: A detailed search of several electronic databases was undertaken to identify randomized controlled trials published before 5 December 2011 that compared PFNA with DHS in patients with trochanteric fractures. RESULTS: A quantitative meta-analysis of 11 studies including 798 patients was performed. PFNA was associated with significant reductions in duration of surgery (weighted mean difference [WMD] −21.38 min; 95% confidence interval [CI] −33.50, −9.26 min), intraoperative blood loss (WMD −176.36 ml; 95% CI −232.20, −120.52 ml), rate of fixation failure (relative risk [RR] 0.27, 95% CI 0.11, 0.62) and rate of postoperative complications (RR 0.46; 95% CI 0.31, 0.70) compared with DHS. CONCLUSION: The use of PFNA for treatment of trochanteric fractures was found to be superior to DHS in terms of the duration of surgery, intraoperative blood loss, and rates of fixation failure and overall complications.

Retracted: Outcome of Short Proximal Femoral Nail Antirotation and Dynamic Hip Screw for Fixation of Unstable Trochanteric Fractures. A Randomised Prospective Comparative Trial

2011 ◽  
Vol 21 (5) ◽  
pp. 531-536 ◽  
Author(s):  
Bhavuk Garg ◽  
Kanniraj Marimuthu ◽  
Vijay Kumar ◽  
Rajesh Malhotra ◽  
Prakash P. Kotwal
Keyword(s):  
Comparative Trial ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation

scholarly journals Randomized comparative study to evaluate the role of proximal femoral nail and dynamic hip screw in unstable trochanteric fractures

2016 ◽  
Vol 2 (3) ◽  
pp. 75
Author(s):  
Shivanand C Mayi ◽  
Sachin Shah ◽  
Sadashiv R Jidgekar ◽  
Arunkumar Kulkarni
Keyword(s):  
Comparative Study ◽  
Functional Outcome ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Stable Fixation ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw

<p class="abstract"><strong>Background:</strong> Treatment of unstable trochanteric fracture is much more challenging than stable fracture. These fractures require stable fixation to minimize the fracture and implant related complications. Need of this study is to assess the suitable implant for stable fixation of unstable trochanteric fracture with less intra and postoperative complications and good functional outcome.</p><p class="abstract"><strong>Methods:</strong> In this prospective randomized comparative study, 64 patients were distributed into two groups. Group A consisted of patients treated by proximal femoral nail (PFN) (n=32) and group B treated by dynamic hip screw (DHS) (n=32). All the patients were evaluated preoperatively and surgery was done according to the group they were allotted. Post-operative follow up was done at 6 weeks, 3, 6 and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Average age of the patients in this study was 51.26±10.24 year. In this study patients were followed up for an average of 10.87±2.61 month. The duration of surgery was shorter in PFN group. Weight bearing was earlier in PFN group than DHS group. Mean functional ability score was better in PFN group with significant gain in function earlier as compared to DHS group.</p><strong>Conclusions:</strong> PFN is a better implant for internal fixation of unstable trochanteric fractures which allows early mobilization and has got better functional outcome score in early postoperative period than DHS

scholarly journals Comparative study between proximal femoral nail and proximal femoral nail antirotation in management of unstable trochanteric fractures

2016 ◽  
Vol 2 (4) ◽  
pp. 354 ◽  
Author(s):  
Manoj R. Kashid ◽  
Tushar Gogia ◽  
Anjan Prabhakara ◽  
Mohammad A. Jafri ◽  
Dilip S. Shaktawat ◽  
...  
Keyword(s):  
Blood Loss ◽  
Functional Recovery ◽  
Proximal Femoral Nail ◽  
Functional Evaluation ◽  
Trochanteric Fractures ◽  
Non Union ◽  
Femoral Nail ◽  
Walking Aids ◽  
Duration Of Surgery ◽  
Proximal Femoral Nail Antirotation

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">In the management of peri-trochanteric fractures, </span>intramedullary (IM) devices have proven advantage over <span lang="EN-GB">extramedullary devices. IM devices</span> allow for stable anatomical fixation of more comminuted fractures without shortening the abductor lever arm or changing the proximal femoral anatomy. Between IM devices like proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA), the helical blade of latter is believed to provide stability, compression and rotational control of the fracture with higher cut out strength. The following study was undertaken in an attempt to compare these two types of Intra-medullary devices<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Between January 2012 and June 2013, 50 patients with unstable intertrochanteric fractures fulfilling inclusion and exclusion criteria, were randomized into 2 groups to undergo CRIF with either standard PFN (n=25) or PFNA (n=25). They were compared in terms of demography, per-operative variables and postoperative parameters including functional evaluation till 1year postoperatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Background demographic variables, fracture type and pre-injury ambulatory status were comparable between the groups. Operative duration of surgery, amount of blood loss and number of fluoroscopic images were significantly lower in PFNA group as compared to PFN group. Post op complications like infection, non-union, cut out/z-effect, loss of reduction, re-operation and mortality rates didn’t differ significantly between the groups. Post op functional recovery as evaluated by pain, use of walking aids and Harris hip scores were similar in both groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> PFNA significantly reduces the operative time, amount of blood loss and fluoroscopic imaging as compared to PFN. However PFNA offers no significant benefits over PFN in terms of post-operative functional recovery or complications<span lang="EN-IN">.</span></p>

Dynamic Hip Screw in Comparison with Proximal Femoral Nail Technique in Intertrochanteric Femur Fracture Patients

2021 ◽  
Vol 15 (11) ◽  
pp. 2966-2968
Author(s):  
Mudir Khan ◽  
Muhammad Siraj ◽  
Abbas Ali
Keyword(s):  
Blood Loss ◽  
Femur Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture ◽  
Better Than

Background: Hip bone fractures are the main cause of concern on a worldwide level. The main two operative techniques involve dynamic hip screw and proximal femoral nail technique. Aim: To compare the dynamic hip screw with proximal femoral nail technique in intertrochanteric femur fracture patients. Study design: Retrospective study Place and duration of study: Department of Orthopaedics, Khyber Teaching Hospital, Peshawar from 1-7-2019 to 30-12- 2021. Methodology: Seventy patients were enrolled and they were divided in two groups; Group 1 patients were operated with dynamic hip screw (DHS) while group 2 patients were operated by proximal femoral nail (PFN) technique. The detailed pre and post-operative clinical information including blood loss, incision size, Harris hip score and rate of complication was documented. Results: The mean age of patients was 58.62±6.71 year with more male patients than females. The Harris hip score of proximal femoral nail technique was better than distal hip screw. The incision length of distal hip screw cases was 7.61±0.89 in comparison to 4.72±0.73 in proximal femoral nail technique cases with a longer duration of surgery and inter-operative blood loss in case of distal hip screw cases. Conclusion: Proximal femoral nail technique is comparatively better than the distal hip screw procedure. Keywords: Proximal femoral nail technique, distal hip screw, Hip fracture

A Comparison of Proximal Femoral Nail Antirotation and Dynamic Hip Screw Devices in Trochanteric Fractures

2009 ◽  
Vol 37 (4) ◽  
pp. 1057-1064 ◽  
Author(s):  
J Zou ◽  
Y Xu ◽  
H Yang
Keyword(s):  
Functional Outcome ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Operation Rate ◽  
Significant Difference ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation

This prospective, randomized study compared the functional outcome and complications associated with a proximal femoral nail antirotation (PFNA) device with those of a traditional extramedullary device, the dynamic hip screw (DHS), in patients with trochanteric fracture. A total of 121 patients were randomized to the PFNA group ( n = 58) or the DHS group ( n = 63). Perioperative information and complications were recorded, and assessments of functional outcome were made. The DHS group required a longer operative time and was associated with greater blood loss than the PFNA group. The re-operation rate was lower in the PFNA group compared with the DHS group, especially in patients with unstable fractures, although there was no statistically significant difference in the overall complication rate between the two groups. There were no significant differences in functional outcome between the PFNA and the DHS groups. In conclusion, the PFNA device is useful in the treatment of trochanteric fractures.

scholarly journals Proximal Femoral Nail versus Dynamic Hip Screw Fixation for Trochanteric Fractures: A Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao Huang ◽  
Frankie Leung ◽  
Zhou Xiang ◽  
Pei-Yong Tan ◽  
Jing Yang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Controlled Trials ◽  
Trochanteric Fractures ◽  
Randomized Controlled ◽  
Femoral Nail ◽  
Hip Screw

Background. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate.Methods. All randomized controlled trials comparing proximal femoral nail and dynamic hip screw in the treatment of trochanteric fractures were included. Articles and conference data were extracted by two authors independently. Data was analyzed using RevMan 5.1 version. Eight trials involving 1348 fractures were retrieved.Results. Compared with DHS fixation, PFN fixation had similar operation time (95% CI: −15.28–2.40,P=0.15). Blood loss and transfusion during perioperative time were also comparable between the two fixations (95% CI: −301.39–28.11,P=0.10; 95% CI: −356.02–107.20,P=0.29, resp.). Outcomes of hospital stay (95% CI: −0.62–1.01,P=0.64), wound complication (95% CI: 0.66–1.67,P=0.82), mortality (95% CI: 0.83–1.30,P=0.72), and reoperation (95% CI: 0.61–1.54,P=0.90) were all similar between the two groups.Conclusion. PFN fixation shows the same effectiveness as DHS fixation in the parameters measured.

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