scholarly journals Comparison of the Sliding and Femoral Head Rotation among Three Different Femoral Head Fixation Devices for Trochanteric Fractures

2015 ◽  
Vol 7 (3) ◽  
pp. 291 ◽  
Author(s):  
Nobuaki Chinzei ◽  
Takafumi Hiranaka ◽  
Takahiro Niikura ◽  
Mitsuo Tsuji ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Femoral Head ◽  
Head Rotation ◽  
Trochanteric Fractures ◽  
Head Fixation ◽  
Fixation Devices

scholarly journals Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 899
Author(s):  
An Sermon ◽  
Ladina Hofmann-Fliri ◽  
Ivan Zderic ◽  
Yash Agarwal ◽  
Simon Scherrer ◽  
...  
Keyword(s):  
Femoral Head ◽  
Failure Load ◽  
Femoral Fractures ◽  
Head Rotation ◽  
Cement Augmentation ◽  
Fixation Strength ◽  
Fixation Stability ◽  
Head Element ◽  
Increasing Cyclic Loading ◽  
The Impact

Background and Objectives: Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures. The aim of this study was to assess the impact of augmentation on the fixation strength of TFN-ADVANCEDTM Proximal Femoral Nailing System (TFNA) blades and screws within the femoral head and compare its effect when they are implanted in centre or anteroposterior off-centre position. Materials and Methods: Eight groups were formed out of 96 polyurethane low-density foam specimens simulating isolated femoral heads with poor bone quality. The specimens in each group were implanted with either non-augmented or cement-augmented TFNA blades or screws in centre or anteroposterior off-centre positions, 7 mm anterior or posterior. Mechanical testing was performed under progressively increasing cyclic loading until failure, in setup simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap. Varus-valgus and head rotation angles were monitored. A varus collapse of 5° or 10° head rotation was defined as a clinically relevant failure. Results: Failure load (N) for specimens with augmented TFNA head elements (screw/blade centre: 3799 ± 326/3228 ± 478; screw/blade off-centre: 2680 ± 182/2591 ± 244) was significantly higher compared with respective non-augmented specimens (screw/blade centre: 1593 ± 120/1489 ± 41; screw/blade off-centre: 515 ± 73/1018 ± 48), p < 0.001. For both non-augmented and augmented specimens failure load in the centre position was significantly higher compared with the respective off-centre positions, regardless of the head element type, p < 0.001. Augmented off-centre TFNA head elements had significantly higher failure load compared with non-augmented centrally placed implants, p < 0.001. Conclusions: Cement augmentation clearly enhances the fixation stability of TFNA blades and screws. Non-augmented blades outperformed screws in the anteroposterior off-centre position. Positioning of TFNA blades in the femoral head is more forgiving than TFNA screws in terms of failure load.

Unstable trochanteric Fracture Fixation with P.F.N. augmented by T.B.W.

2021 ◽  
Vol 8 (1) ◽  
pp. 39-42
Author(s):  
Dr. Vijay Patil ◽  
Dr. Pandurang Daule ◽  
Dr. Deepak Naikwade
Keyword(s):  
Femoral Head ◽  
Trochanteric Fracture ◽  
Bony Union ◽  
Age Group ◽  
Lateral Migration ◽  
Trochanteric Fractures ◽  
Screw Breakage ◽  
Hip Function ◽  
The Stability

Biomechanically Proximal Femoral Nail (PFN) is a better choice of implant. Still it is associated with screw breakage, cut out through femoral head,”Z” effect, reverse “Z” effect and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of post operative complication and failure rates in unstable trochanteric fracture. Methodology: We did study of 21 unstable trochanteric fractures from Jan 2016 to Nov .2020. 14 patients were males & 7 patients were females. Age group between 25 to 80 was included in this group. There were 15 A0 A2 (2.2, 2.3) and 6 were A0 A3 (3.1, 3.2, 3.3). All fractures were fixed with 25cm, 1350 PFN mainly 11 mm, 12mm in diameter augmented with one or two 16 gauge tension band wire, strengthening lateral trochanteric wall and holding either communiated   fragments or lesser trochanteric fracture. Results: The bone healing was observed in all cases with mean period of 16 weeks. Two patients developed complication of TBW breakage; one developed lateral migration of screws. Patients were followed till # union. At the end of follow up the Salvati and Wilson hip function was 30 (out of 40) in 80% patients. Conclusion: The stabilization of lateral trochanteric wall fracture and communicated fragments with additional one or two TBW increases the stability of construct enhancing bony union & better results.

Necrosis of the femoral head after fixation of trochanteric fractures with Gamma Locking Nail

Injury ◽  
2003 ◽  
Vol 34 (2) ◽  
pp. 129-134 ◽  
Author(s):  
C. Vicario ◽  
F. Marco ◽  
L. Ortega ◽  
M. Alcobendas ◽  
I. Dominguez ◽  
...  
Keyword(s):  
Femoral Head ◽  
Trochanteric Fractures ◽  
Locking Nail

scholarly journals Contribution to the method for determining femoral neck axis

2014 ◽  
Vol 142 (3-4) ◽  
pp. 178-183 ◽  
Author(s):  
Zoran Andjelkovic ◽  
Desimir Mladenovic ◽  
Zoran Vukasinovic ◽  
Stojanka Arsic ◽  
Milorad Mitkovic ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Small Sample Size ◽  
Alpha Angle ◽  
Head Rotation ◽  
Small Sample ◽  
Femoral Neck Axis ◽  
Rotation Center ◽  
Head Translation ◽  
Head Neck

Introduction. Femoral neck axis plotting is of great significance in measuring parameters that define femoral head-neck junction sphericity in the group of patients with the femoroacetabular impingement. Literature methods of femoral neck axis determination have weaknesses associated with the risk of obtaining inaccurate values of certain parameters. Objective. Method of plotting of the femoral neck axis by two parallel lines that belong to the medial quarter of the femoral neck is proposed. Method was tested on the anatomic specimens and the respective radiograms. Methods. A total of 31 anatomic specimens of the proximal femur and respective radiographs were used, on which three axes of the femoral neck were plotted; accordingly, alpha angle value was determined and tested with corresponding parametric tests, with the measurement error of less than 5% and the strength of the applied tests of 80%. Results. Alpha angle values obtained by plotting femoral neck axis using the literature and methods we have proposed were not significantly different in our series, and, in more than a half of the specimens, the two axes overlapped each other. Conclusion. The advantage of the proposed method does not depend on the position of the femoral head rotation center in relation to the femoral neck, which favors proposed method for measuring the angles of femoral head sphericity in patients with the femoral head translation. Disadvantage of the study is a small sample size for valid conclusions about the applicability of this method in clinical practice.

Ossovenography as a reliable method of diagnosing postoperative necrosis of the femoral head in the presence of internal fixation devices

1997 ◽  
Vol 100 (12) ◽  
pp. 943-948
Author(s):  
M. Wick ◽  
A. Ekkernkamp ◽  
A. Weber ◽  
A. Bosse ◽  
J. Szita ◽  
...  
Keyword(s):  
Femoral Head ◽  
Internal Fixation ◽  
Reliable Method ◽  
Fixation Devices

scholarly journals Breakage in Two Points of a Short and Undersized “Affixus” Cephalomedullary Nail in a Very Active Elderly Female: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Giuseppe Rollo ◽  
Giuseppe Rinonapoli ◽  
Paolo Pichierri ◽  
Michele Bisaccia ◽  
Auro Caraffa ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Functional Results ◽  
Subtrochanteric Fracture ◽  
Revision Hip Arthroplasty ◽  
Trochanteric Fractures ◽  
Cephalomedullary Nail ◽  
Elderly Female ◽  
First Case ◽  
Fixation Devices ◽  
Scientific Papers

Introduction. Trochanteric fractures of the femur are common in elderly individuals with osteoporosis. The use of cephalomedullary nails is increasing, and they are now the most commonly used fixation devices, especially for the treatment of unstable trochanteric fractures. The nail breakage is not the most common complication of intramedullary nailing. Many scientific papers report nail breakage in a specific location: through the lag screw hole, the nail shaft, or the distal locking hole. Materials and Methods. We present a case of an 84-year-old patient treated with modular revision hip arthroplasty due to the breakage in two points of a cephalomedullary nail implanted 3 years earlier for a subtrochanteric fracture. Results. After modular revision hip arthroplasty, the functional results and quality of life have been excellent. Conclusions. As far as we could determine, this appears to be the first case of a breakage of a cephalomedullary nail in two points after nonunion in a very active elderly female.

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