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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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

10.36106/gjra/8411863 ◽

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.

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Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing

Annals of International medical and Dental Research ◽

10.53339/aimdr.2022.8.1.18 ◽

2022 ◽

Vol 8 (1) ◽

pp. 132-140

Author(s):

Girish Sahni

Keyword(s):

Excellent Result ◽

Tertiary Care ◽

Subtrochanteric Fracture ◽

Proximal Femoral Nail ◽

Harris Hip Score ◽

Subtrochanteric Fractures ◽

Femoral Nail ◽

One Year ◽

Modified Harris Hip Score ◽

A Prospective Study

Background: Numerous variations of intramedullary nailing have been evolved over the years for stable fixation and early mobilisation of subtrochanteric fracture, out of which one is proximal femoral nail. Aims and objectives –We conducted this study with an objective to evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail – AO type Design.Methods:This was a prospective study carried out at our tertiary care institute on 30 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.Results:Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 21 patients (70%), good results in 3 cases(10%), fair results in 3 patient (10%) and poor results in 3 cases(10%). The mean Harris hip score in our study was 90.6.Conclusion:PFN is an intramedullary load sharing implant. Reduction and management of subtrochanteric fractures is challenging in traumatology. Proximal femoral nailing spanning whole femur with proximal and distal locking appears to be a satisfactory implant in management of fractures of subtrochanteric femur.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200739 ◽

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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Critical analysis of factors determining mechanical failures in proximal femoral nailing

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190504 ◽

2019 ◽

Vol 5 (2) ◽

pp. 275 ◽

Cited By ~ 1

Author(s):

Karthik Ramachandran ◽

K. K. Arvind Manoj ◽

A. Vishnu Sankar

Keyword(s):

Failure Rate ◽

Mechanical Failure ◽

Proximal Femoral Nail ◽

Harris Hip Score ◽

Intertrochanteric Fractures ◽

Excellent Outcome ◽

Lag Screw ◽

Femoral Nailing ◽

Femoral Nail ◽

Proximal Femoral Nailing

Background: Intertrochanteric fractures are one of the commonest fractures encountered in elderly population. Though there are various implants, proximal femoral nail has been the standard choice for management of unstable fractures. Inspite of its biomechanical advantages, various complications like screw cut out, Z effect, reverse Z effect does occur in proximal femoral nailing. The aim of the study is to analyse various factors determining the mechanical failures in patients operated with proximal femoral nail.Methods: This is a prospective study conducted in our institution from June 2014 to May 2018. The study included 72 patients with unstable intertrochanteric fractures treated with proximal femoral nail. All patients were followed for average period of 2 years. Functional outcome was assessed using Harris Hip score.Results: Among the patients 33% had excellent outcome. 42% had good and 14% had fair outcome. 11% of cases ended with poor outcome. Mechanical failure rate was less in patients with positive medial cortical support (PMCS) and in patients with tip apex distance difference between antirotation screw and lag screw (TADAR -TADLS) more than 15 mm. Whereas the difference in the position of lag screw centre had no significant influence in the mechanical failure rate in our study.Conclusions: From our study we like to conclude that the fracture reduction with positive medial cortical support and the TAD difference play a major role in determining the incidence of mechanical failure in proximal femoral nailing.

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SURGICAL OUTCOMES OF SUBTROCHANTERIC FRACTURES OF FEMUR TREATED WITH PROXIMAL FEMORAL NAIL (PFN)

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2016/779 ◽

2016 ◽

Vol 5 (52) ◽

pp. 3373-3377

Author(s):

Jenson Isaac ◽

Vijay Krishna ◽

Ranjith Kumar ◽

Shanmugavel Shanmugavel

Keyword(s):

Surgical Outcomes ◽

Proximal Femoral Nail ◽

Subtrochanteric Fractures ◽

Femoral Nail

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A Prospective Randomized Control Trial Comparing Proximal Femoral Nail and Sliding Hip Screw in The Management of Trochanteric Fracture of The Femur

Health Renaissance ◽

10.3126/hren.v9i1.4354 ◽

1970 ◽

Vol 9 (1) ◽

pp. 7-11

Author(s):

NK Kam ◽

Ashis Jain ◽

P Nepal ◽

Mahi Pal Singh ◽

N Das

Keyword(s):

Controlled Trial ◽

Trochanteric Fracture ◽

Proximal Femoral Nail ◽

Joint Disease ◽

Harris Hip Score ◽

Sliding Hip Screw ◽

Femoral Nail ◽

Number Of Patients ◽

Hip Screw ◽

Screw Group

Introduction: There are various implants designed for fixation of trochanteric fracture which can be extramedullary (Sliding hip screw) and intramedullary (Proximal Femoral Nail). A randomized controlled trial comparing these techniques was conducted at BP Koirala Institute of Health Sciences. Objective: To compare efficacy of proximal femoral nail and sliding hip screw in the management of trochanteric fractures. Methods: Patients in both groups were matched for age (mean 67 years, 50 to 100) and gender. We excluded all pathological fractures, patients presenting at more than one week, multiple fractures or any bone and joint disease interfering with rehabilitation. Results: The amount of blood loss and length of incision were significantly higher in the sliding hip screw group (p < 0.05). The time of union, range of movement and Western Ontario and McMasterUniversity knee scores were comparable at two years. The mean Harris hip score was better in proximal femoral group. Conclusion: The number of patients showing shortening, external malrotation and varus angulation was more in sliding hip screw group. There was one case of wound infection and a single case of breakage of implant in sliding hip screw group. Keywords: fracture trochanter; proximal femoral nail; sliding hip screw DOI: 10.3126/hren.v9i1.4354Health Renaissance, 2011: Vol.9 No.1:7-11

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Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-017-1415-6 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 13

Author(s):

Xianshang Zeng ◽

Ke Zhan ◽

Lili Zhang ◽

Dan Zeng ◽

Weiguang Yu ◽

...

Keyword(s):

Retrospective Study ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Total Hip ◽

Femur Fractures ◽

Femoral Nail ◽

Hip Screw

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

Medical Archives ◽

10.5455/medarh.2015.69.352-356 ◽

2015 ◽

Vol 69 (6) ◽

pp. 352 ◽

Cited By ~ 2

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

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Functional and Radiological Outcome of Unstable Intertrochanteric Fracture in Old Age Treated with Proximal Femoral Nail Antirotation-2

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47653.14751 ◽

2021 ◽

Author(s):

OP Jamshad ◽

Jacob Mathew ◽

Raju Karuppal

Keyword(s):

Proximal Femoral Nail ◽

Harris Hip Score ◽

Intertrochanteric Fractures ◽

Biological Reduction ◽

Neck Shaft Angle ◽

Femoral Nail ◽

Unstable Intertrochanteric Fracture ◽

Shaft Angle ◽

The Mean ◽

Proximal Femoral Nail Antirotation

Introduction: Intertrochanteric fractures are prevalent in the elderly, which leave patients with functional restrictions. Proximal Femoral Nail Antirotation-2 (PFNA) was developed to achieve better fixation strength, particularly in the presence of osteoporotic unstable intertrochanteric fractures. Aim: To evaluate the role and result of PFNA-2 in the treatment of unstable intertrochanteric fractures in geriatric patients. Materials and Methods: A prospective analytical study was conducted in 35 patients with unstable intertrochanteric fractures. They were followed-up clinically and radiologically for one year. The quality of fixation was assessed, by neck-shaft angle and Tip Apex Distance (TAD). A functional assessment was done with the Harris Hip Score (HHS). Results: The mean follow-up period was 13 months (range, 12-14). The mean age of patients was 65.6 years and the majority were female patients (62.85%). Functional results according to modified HHS were found to be excellent in 6 (17.1%) patients, good in 14 (40%) patients, fair in 12 (34.3%) patients and poor in 3 (8.6%) patients. The average HHS in this study was 81.6. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16.0. Conclusion: PFNA-2 helps in achieving biological reduction and good stability which enables early mobilisation and prevention of excessive collapse. A good functional outcome could be achieved when the radiological parameters are restored, i.e., TAD <25 mm and neck-shaft angle difference <5° (compared to the opposite side).

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COMPARATIVE STUDY OF HEMIREPLACEMENT ARTHROPLASTY WITH BIPOLAR PROSTHETIC AND PROXIMAL FEMORAL NAIL (PFN) IN UNSTABLE INTERTROCHANTERIC FRACTURE OF FEMURE: INTERVENTIONAL PROSPECTIVE RANDOMIZED STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i12.2337 ◽

2021 ◽

Vol 5 (12) ◽

Author(s):

Sawai Singh ◽

Raghuveer Meena

Keyword(s):

Randomized Study ◽

Proximal Femoral Nail ◽

Harris Hip Score ◽

P Value ◽

Bipolar Group ◽

Femoral Nail ◽

Keywords Hip ◽

Unstable Intertrochanteric Fracture ◽

Keywords Hip Arthroplasty ◽

Intertrochanteric Femur Fracture

Background: Intertrochanteric femur fracture incidence has increased due to increased life expectancy and osteoporosis. Methods- The present study was prospectively carried out in 60 consecutive patients of Fracture Intertrochanter Femur and treated with Hemiarthroplasty with Cemented Bipolar Prosthesis and Proximal Femoral Nail. Results: The age of the patients in present study was in range of 60 - 80 years. There was a preponderance of female in present study in both groups. The mean duratioin of surgery in the Bipolar group (91.24±9.21Minutes) was much More That In PFN (53.12 ±6.02Minutes) Group. All patients of Bipolar group was discharged between 4 to 9 days and in PFN group 4 to 12 days after surgery. The average harris hip score in PFN group is 87.32±4.13 and in Bipolar group is 85.02±7.92. Final functional outcome were better in PFN group (P value 0.01) than by Bipolar group and significant. Conclusion: The outcomes of the stable fractures treated with either Bipolar or PFN were similar. Unstable comminuted fractures treated with Bipolar showed significantly better outcomes with all patients having good results. Keywords: Hip Arthroplasty, PFN, Complication

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