scholarly journals A prospective study of management of subtrochanteric femur fracture using proximal femoral nail

2020 ◽  
Vol 6 (2) ◽  
pp. 292
Author(s):  
Shwetabh Malik ◽  
Parimal Malviya ◽  
Alfven Vieira ◽  
Deepak Jain
Keyword(s):  
Proximal Femur ◽  
Femur Fracture ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Medullary Canal ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femur Fractures ◽  
Femoral Nail

<p class="abstract"><strong>Background:</strong> Proximal femur fractures present considerable challenge in management. They are due to high velocity trauma, with or without soft tissue injury and usually with a metaphyseal and diaphyseal involvement. The surgeon has to face many challenges like identifying the entry, reduction the fracture, and difficulty due to a narrow medullary canal and comminution. The present study was conducted to assess the utility and effectiveness of Proximal Femoral Nail for subtrochanteric fractures of femur.</p><p class="abstract"><strong>Methods:</strong> In this study a total of 30 patients with Sub trochanteric femur fracture admitted to MGM medical college and hospital from June 2015 to July 2017 were selected for treatment with proximal femur nail.<strong></strong></p><p class="abstract"><strong>Results:</strong> 30 patients were included in this study with subtrochanteric fractures of femur treated with Proximal femoral nail. Maximum 21(70%) of patients were below 61 yrs of age. Mean age was 47.9 years. There was 21 male and 9 females in the study.  There were 6 patients with local complications. Final result of our study, we had 26.7% excellent, 46.6% good, 20% fair and 6.7 % poor results according to Harris hip score.</p><p class="abstract"><strong>Conclusions:</strong> In our study, looking at the results we found that Proximal femoral Nail proves to be a good implant in management of subtrochanteric fractures of femur.  However, it is a small study to conclude anything definitely.</p>

scholarly journals Retrospective study for the results of proximal femoral nailing in subtrochanteric fractures

2020 ◽  
Vol 6 (4) ◽  
pp. 699
Author(s):  
Manthan H. Mandalia ◽  
Hasmukh L. Kubavat ◽  
Nirav Trivedi
Keyword(s):  
Retrospective Study ◽  
Age Groups ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Stable Fixation ◽  
Early Mobility ◽  
Subtrochanteric Fractures ◽  
Femoral Nail ◽  
Intramedullary Implant ◽  
Returning To Work

<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures are prevalent in young and old age groups and one of the most notorious to achieve a stable fixation which allows early union and mobilization. This was a retrospective study to analyse the outcomes of proximal femur nailing in subtrochanteric fractures and assess the functional outcome, radiological union and compare that with studies of other modalities.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study of 40 patients with sub trochanteric fractures classified by Sienshiemer classification and operated by proximal femoral nail implant. Clinical evaluation was done by Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average union time in our study was 5.12 months lower than some of the union rates of series with other implants (AO blade plate 7.7%). The conducive environment provided by proximal femoral nail (PFN) allows early mobility, independence to the patient and lessens the complications due to the bed ridden state and decrease the time in returning to work.</p><p class="abstract"><strong>Conclusions:</strong> Our study suggests that PFN being and intramedullary implant gives stable fixation and early union as compared to extramedullary implants with less blood loss and less complications.</p>

scholarly journals Outcome of proximal femur fracture treated with long proximal femoral nail and dynamic hip screw

2017 ◽  
Vol 3 (3i) ◽  
pp. 600-606
Author(s):  
Dr. Arvind Kumar ◽  
Dr. Anurag Jain ◽  
Dr. Aditya Agrawal ◽  
Dr. Malkesh Sah ◽  
Dr. Anirudh Bansal ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Femur Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Proximal Femur Fracture ◽  
Femoral Nail ◽  
Hip Screw

A PROSPECTIVE COMPARISON OF THE PROXIMAL FEMORAL NAIL VERSUS THE PROXIMAL FEMORAL LOCKING PLATE IN SUBTROCHANTERIC FEMORAL FRACTURES.

2021 ◽  
pp. 65-69
Author(s):  
Dinesh Kumar Bairwa ◽  
Jitendra Aloria ◽  
Vishnu Prasad ◽  
Ashok Kumar Tiwari
Keyword(s):  
Locking Plate ◽  
Weight Bearing ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femoral Nailing ◽  
Femoral Nail ◽  
Prospective Comparison ◽  
Anatomic Reduction ◽  
Proximal Femoral Nailing

BACKGROUND: Subtrochanteric fractures account for 10% to 30% of all hip fractures. The fractures were repaired with a variety of implants. Direct anatomic reduction or indirect reduction and bridge plating procedures are also possible with the proximal femoral locking plate (PFLP). Proximal femoral nails (PFN) have been demonstrated to be superior to other implants due to biomechanical advantages. The goal of this study was to compare the radiological and functional outcomes of subtrochanteric fractures treated with the proximal femoral nail (PFN) and the proximal femoral locking plate (PFLP), in order to determine which implant was the best t for the specic fracture pattern. METHODS: 50 patients with a Subtrochanteric femur fracture were operated on and treated with a proximal femoral nail and a proximal femoral locking plate (25 in each group). A 24-month follow-up was completed. The Harris Hip Score (HHS) and radiological results were used to determine the outcome. When compared to patients treated wit RESULTS: h a proximal femoral locking plate, individuals treated with proximal femoral nailing required considerably less time to achieve complete weight bearing. In patients treated with a proximal femoral locking plate, radiological union was considerably delayed compared to patients treated with proximal femoral nailing. The average HHS in the nailing group was slightly higher than in the plating group. PFN have the advantage by taking less operative time, high rate of union, mi CONCLUSION: nimal soft tissue damage, less infection rate and early postoperative rehabilitation. In our research, we discovered that both PFN and PFLP can be utilised successfully to treat Subtrochanteric fractures. In terms of anatomical alignment, limb length disparity, postoperative infection, and, most critically, the nal Harris Hip Score, there was no signicant difference between implants.

scholarly journals EVALUATION FUNCTIONAL OUTCOME OF HELICAL FIXATION PFN A2 IN PROXIMAL FEMUR FRACTURE IN ELDERLY

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Sawai Singh ◽  
Ram Chander
Keyword(s):  
Comparative Study ◽  
Functional Outcome ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Proximal Femoral Nail ◽  
Proximal Femur Fracture ◽  
Mortality And Morbidity ◽  
Femoral Nail ◽  
Proper Training ◽  
Intertrochanteric Femur Fracture

Background: Intertrochantric fractures are the most frequently operated fractures and has the highest mortality and morbidity rates. Evaluation functional outcome of helical fixation pfn a2 in proximal femur fracture in elderly Methods: Hospital based prospective randomized comparative study conducted on 30 patients with  Close  stable &unstable intertrochanteric femur fracture. Results: As per HHS, we have found that 76.67% cases (23) under excellent category and 20.00% (6) good and 3.33% (1) fair of HHS. Conclusion: We can conclude that the PROXIMAL FEMORAL NAIL ANTIROTATION2 is after proper training and technique a safe and easy implant option for treatment of complex peritertrochanteric fractures. Keywords: HHS, Femur, fracture

scholarly journals TO EVALUATE THE EFFICACY OF KICK STAND SCREW IN FIXATION OF SUBTROCHANTERIC FEMORAL FRACTURES USING CONTRALATERAL REVERSED DISTAL FEMORAL LOCKING PLATEPROSPECTIVE SINGLE CENTRIC STUDY

2020 ◽  
pp. 1-4
Author(s):  
Prashant Pandey ◽  
K K Pandey ◽  
Ajay Dhanopeeya ◽  
Surya Prakash Garg
Keyword(s):  
Proximal Femur ◽  
Locking Plate ◽  
Harris Hip Score ◽  
Plate Bending ◽  
Neck Shaft Angle ◽  
Subtrochanteric Fractures ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Shaft Angle

PURPOSE- All type of plates when used for proximal femur fractures always has chances of mechanical failure due to lack of strength of the construct, but addition of ‘kick stand screw’ has some effects on stability of the construct. Aim of our study is to evaluate the efficacy of kick stand screw in fixation of subtrochanteric fractures using contralateral reversed distal femoral locking plate. METHOD- 30 patients of subtrochanteric fractures fixed using contralateral reversed distal femoral locking plate. N(1st)=15 fixed without kick stand screw and other N(2nd)=15 fixed using kick stand screw. Calcar screw( Kick Stand Screw) is placed to support calcar region (inferior to the center in AP view and central in Lateral view). In other group screws are placed as oriented in screw holes. Outcome was assessed using Harris Hip Score and VAS score and change in the neck shaft angle is also followed. RESULT- Union rate was 80% in 1st group as compare to 94% in second group. Mean Harris hip score at the one year follow up was 71.2 in 1st group as compare to 89.2 in 2nd group. Mean Visual analogue scale was 3.2 in first group as compare to 1.6 in second group at final follow up. Mean neck shaft angle at final follow-up was 120 degree in first group as compared to135 degree in second group. Complication- 1st Group of patients had three failures 2 in the form of screw break down and one in the form of plate bending, all three lend up in to varus deformity but the 2nd group had only one failure in the form of plate bending. CONCLUSION-In our study cases in which kick stand screw was used they showed better mechanical strength and gave better clinical results. So in proximal femur fractures including subtrochanteric fracture fixation ‘kick stand screw’ must be used.

scholarly journals Functional and radiological outcome of osteosynthesis using proximal femoral nail antirotation II system in intertrochanteric femoral fractures

2021 ◽  
Vol 7 (2) ◽  
pp. 267
Author(s):  
Wajahat Ahmad Mir ◽  
Mohmad Nawaz Rather ◽  
Rasiq Rashid
Keyword(s):  
Morbidity And Mortality ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Common Source ◽  
Intertrochanteric Fractures ◽  
College Hospital ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are relatively common injuries in adults and a common source of morbidity and mortality among the elderly. Incidence of fractures is increasing because the general life expectancy of the population has increased significantly during the past few decades. Stable fixation and early mobilization is needed in these fractures to reduce the morbidity and mortality. Extra-medullary implants are biomechanically inferior in these cases. The proximal femoral nail antirotation-II (PFNA-II) is an intra-medullary nail system designed for such fractures. The purpose of this study was to assess the results and complications of PFNA-II in intertrochanteric femur fractures.</p><p class="abstract"><strong>Methods:</strong> After seeking approval from institutional Ethical committee, this study was conducted on 30 patients attending our emergency department with intertrochanteric femur fractures at SKIMS Medical College Hospital Bemina, Srinagar from February 2018 to June 2019. The patients were treated with proximal femoral nail antirotation-II. Follow up was done at 2, 6, 12 and 24 weeks.  The functional outcome was assessed at 6 months follow up using the Harris Hip Score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Based on the Harris hip score, 18 (60%) patients had excellent results, 10 (33%) had good results and 2 (7%) had Fair results. None of the patients had poor result. Average time to union was 12.27 weeks.</p><p class="abstract"><strong>Conclusions:</strong> This study found the PFNA-II to be a versatile, easy to use and dependable implant for stable as well as unstable intertrochanteric fractures. PFNA II is distinct advance over the previous methods of treatment, though it has an initial learning curve.</p>

scholarly journals Evaluation of clinical results and complications of internal fixation of intertrochanteric femur fracture with proximal femoral nail antirotation

2019 ◽  
Vol 5 (2) ◽  
pp. 283 ◽  
Author(s):  
Manish Raj ◽  
S. P. S. Gill ◽  
Akashdeep Singh ◽  
Ajay Kumar Rajput ◽  
Santosh Kumar Singh
Keyword(s):  
Functional Outcome ◽  
Varus Deformity ◽  
Clinical Results ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Significant Treatment ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Proximal Femoral Nail Antirotation

<p class="abstract"><strong>Background:</strong> The purpose of the present study was to evaluate the theoretical advantages of the proximal femoral nail antirotation in cases of intertrochanteric fractures and also whether it actually alters the eventual functional outcome of the patient.</p><p class="abstract"><strong>Methods:</strong> The present study includes a total 30 patients with intertrochanteric femur fractures managed with proximal femoral nail antirotation between December 2014 to November 2016. In all patients similar standard physical rehabilitation therapy were followed. All complications including intra and postoperative were assessed and recorded. The patients were followed up for over 24 months. Functional outcome was assessed using the Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> All of 30 cases of intertrochanteric fracture got united with good anatomical position and average time of fracture union was 14 weeks. Postoperative complications included 2 degree varus deformity (n=1, 3%), calcification at tip of greater trochanter (n=4, 13%), sensitivity over TFL (n=2, 7%), medial thigh pain (n=3, 10%). 10 patients developed femoral shortness (mean=0.22 cm, range from 0-1 cm). Average harris hip score at the end of study showed mean value of 87, ranged from 65 to 94 with almost 22 (73%) patients showing excellent or good outcome.</p><p class="abstract"><strong>Conclusions:</strong> Proximal femoral nail antirotation (PFNA) represents a significant treatment option in management of intertrochanteric fractures with low complication rate.</p>

scholarly journals INTERTAN nail versus proximal femoral nail antirotation-Asia for intertrochanteric femur fractures in elderly patients with primary osteoporosis

2017 ◽  
Vol 45 (4) ◽  
pp. 1297-1309 ◽  
Author(s):  
Hui Zhang ◽  
Xianshang Zeng ◽  
Nan Zhang ◽  
Dan Zeng ◽  
Ping Xu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Primary Osteoporosis ◽  
Femur Fractures ◽  
Femoral Nail ◽  
Increased Risk ◽  
Proximal Femoral Nail Antirotation ◽  
Intertan Nail

Objectives To compare the long-term functional and radiographic outcomes of the proximal femoral nail antirotation-Asia (PFNA-II) and INTERTAN nail (IT) in the management of intertrochanteric femoral fractures (IFFs) (AO/OTA Type 31A1.1-A2.3) in elderly patients with primary osteoporosis. Methods A retrospective comparative study was performed in our institution. From January 2009 to March 2012, 243 patients with osteoporosis (243 hips) with IFFs (AO/OTA Type 3.1A1.1-A2.3) underwent repair with either a PFNA-II or IT. Follow-up assessments were performed 1, 3, 6, 9, and 12 months postoperatively and every year thereafter. All implant position changes were noted. Patient-related functional outcomes were evaluated based on the Harris hip score. Results In total, 174 patients with osteoporosis (IT, n = 86; PFNA-II, n = 88) were evaluated during a mean follow-up period of 40 months (range, 38–60 months). An increased risk of femoral shaft fracture after implant removal was observed at month 9 of follow-up in 0.0% and 4.4% of the IT and PFNA-II groups, respectively. This difference remained over time with rates of 1.1% and 6.8%, respectively, at the last follow-up. Conclusion The IT nail appears to be a reliable implant in the management of IFFs (AO/OTA Type 3.1A1.1-A2.3) in elderly patients with primary osteoporosis.

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