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

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

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Mode of Fixation Failures of Dynamic Hip Screw with TSP in the Treatment of Unstable Proximal Femur Fracture: Biomechanical Analysis and a Report of 3 Cases

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2006.41.1.176 ◽

2006 ◽

Vol 41 (1) ◽

pp. 176 ◽

Cited By ~ 4

Author(s):

Soo Yong Kang ◽

Eun Woo Lee ◽

Ki Ser Kang ◽

Kwang Sup Song ◽

Sang Hak Lee ◽

...

Keyword(s):

Proximal Femur ◽

Femur Fracture ◽

Dynamic Hip Screw ◽

Biomechanical Analysis ◽

Proximal Femur Fracture ◽

Hip Screw

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

10.53350/pjmhs2115112966 ◽

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

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A Comparatives Study of Unstable Intertrochanteric Fracture of Femur Treated with Dynamic Hip Screw Versus Proximal Femoral Nail

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2019.11.04.105 ◽

2019 ◽

Vol 11 (4) ◽

Keyword(s):

Intertrochanteric Fracture ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Femoral Nail ◽

Unstable Intertrochanteric Fracture ◽

Hip Screw

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Energia necessária para a ocorrência de fratura em modelos sintéticos de fêmur proximal após retirada de material de síntese: um estudo biomecânico com parafuso canulado, parafuso dinâmico do quadril e haste femoral proximal

Revista Brasileira de Ortopedia ◽

10.1055/s-0040-1721832 ◽

2021 ◽

Author(s):

Anderson Freitas ◽

Landwehrle de Lucena da Silva ◽

Renilton Rodrigues Costa ◽

Lucas Sacramento Ramos ◽

Marcos Norberto Giordano ◽

...

Keyword(s):

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Femoral Nail ◽

Hip Screw

Resumo Objetivo Identificar a energia necessária para ocorrência de fratura do fêmur proximal em osso sintético após retirada de três modelos de implantes: parafusos canulados, parafuso dinâmico do quadril (dynamic hip screw-DHS) e haste femoral proximal (proximal femoral nail-PFN). Métodos Foram utilizados 25 modelos de ossos sintéticos da extremidade proximal do fêmur: 10 unidades de grupo controle (GC), 5 unidades após colocação e retirada de 3 parafusos canulados colocados em configuração de triângulo invertido (GPC), 5 unidades após colocação e retirada do parafuso de compressão dinâmico (GDHS), e 5 unidades após colocação e retirada da haste de fêmur proximal (GPFN). Uma análise biomecânica foi realizada em todas as amostras simulando uma queda sobre o grande trocânter utilizando uma máquina servo-hidráulica com o objetivo de verificar a energia (em Joules [J]) necessária até a ocorrência de fratura nos diferentes grupos. Resultados Todos os grupos apresentaram fratura basocervical. Os grupos GC, GPC, GDHS e GPFN apresentaram, respectivamente, valores de 7.1J, 6.6J, 6J e 6.7J de energia até ocorrência da fratura. Não houve diferença estatisticamente significativa (intervalo de confiança de 95%) na energia entre os grupos de estudo (p = 0,34). Conclusão Não houve diferença estatisticamente significativa nos valores de energia necessária para ocorrência de fratura da extremidade proximal do fêmur após a retirada de três tipos de implantes utilizando modelos sintéticos simulando queda sobre o grande trocânter.

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A study to assess proximal femoral nailing versus dynamic hip screw device in surgical management of intertrochanteric fractures: a comparative study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20184719 ◽

2018 ◽

Vol 5 (1) ◽

pp. 23

Author(s):

E. S. Radhe Shyam ◽

K. Ashwin

Keyword(s):

Functional Outcome ◽

Intertrochanteric Fracture ◽

Trochanteric Fracture ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Technical Failure ◽

Intertrochanteric Fractures ◽

Femoral Nail ◽

Fracture Management ◽

Hip Screw

Background: The incidence of inter trochanteric fracture is expected to have doubled by 2040. Inter trochanteric fractures account for about 45% to 50% of all hip fractures in the elderly populationand out of these, near about 50% to 60% are classified as unstable intertrochanteric fractures. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure. This study as performed to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.Methods: It was prospective observational study done for a period of 1year from January 2016-January 2017 among patients who attended OPD or emergency department with intertrochanteric fracture. Two different implants were used dynamic hip screw (DHS) and proximal femoral nail (PFN).Results: Excellent results in functional outcome was more in case of PFN (66.6%) compared to DHS (50%). The type of trauma in DHS group was road traffic accident in 38.8%, domestic fall in 50% and others such as assault was in 11.1% while in PFN group intertrochanteric fracture was seen in 61.1% due to domestic fall.Conclusions: The functional outcome was more better with proximal femoral nail (PFN) compared to dynamic hip screw (DHS). Therefore, proximal femoral nail (PFN) should be preferred for management of intertrochanteric fractures.

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Dynamic Hip Screw versus Proximal Femoral Nail in the Management of Intertrochanteric Fractures - A Retrospective Analysis from Rajasthan

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/424 ◽

2021 ◽

Vol 8 (26) ◽

pp. 2271-2277

Author(s):

Gajanand Shriram Dhaked ◽

Abhishek Komalsingh Jaroli ◽

Khushboo Parmanand Malav ◽

Harish Narayan Singh Rajpurohit

Keyword(s):

Functional Outcome ◽

Functional Outcomes ◽

Statistical Significance ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Final Decision ◽

Intertrochanteric Fractures ◽

Femoral Nail ◽

Duration Of Surgery ◽

Hip Screw

BACKGROUND Current management of Intertrochanteric (IT) fractures has evolved with the introduction of dynamic hip screw (DHS) and proximal femoral nail (PFN). The purpose of this study was to compare the functional outcomes between the DHS and PFN for IT fracture fixation. METHODS This study is a retrospective comparative analysis of 455 patients with IT fractures; DHS (292) and PFN (163), who were treated from June 2012 to June 2015. The patients were reviewed postoperatively for a minimum of 12 months to evaluate functional outcome using Salvati-Wilson score. Categorical data was present as absolute number or percentages, and parametric variables were presented as Mean ± SD, while non parametric data were presented as median. Statistical significance was defined as P < 0.05. RESULTS Intramedullary nails offer no advantage over extramedullary devices to treat IT fractures caused by low-energy trauma (AO 31 - A1). However, clinically significant outcomes were established for PFN group in terms of duration of surgery, x- ray exposure and SW Score for AO / OTA 31 - A2 and 31 - A3. Reoperations encountered for local pain due to implant prominence were significantly higher in the PFN group (4.90 % versus 1.02 %). Kaplan Meier survival probability of 69.3 % and 79.5 % predicted for DHS and PFN respectively, 3 years postoperatively. CONCLUSIONS Our conclusion reinforces indication for PFN in unstable IT fractures (31 - A2 and 31 - A3), owing to its better functional outcome and biomechanical properties. Functional outcomes for stable IT fracture (AO 31 - A1) were comparable between DHS and PFN, therefore final decision for implant choice depends on implant cost, surgeon’s preference for specific technique. However, understanding the morphology of proximal femur, peritrochanteric region is crucial to analyse the anatomical variations in Indian population which will provide the basis for intramedullary nail design modifications. KEYWORDS Intertrochanteric Fractures, DHS Fixation, PFN Fixation

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