scholarly journals Study of effectiveness of coxofemoral bypass in comparison to proximal femoral nail in the treatment of unstable intertrochanteric fractures in the elderly

2018 ◽  
Vol 10 (1) ◽  
pp. 19
Author(s):  
NarendraReddy Medagam ◽  
Babul Reddy
Keyword(s):  
The Elderly ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Femoral Nail

scholarly journals Comparison of Clinical Outcomes With Proximal Femoral Nail Anti-rotation Versus Bipolar Hemiarthroplasty for the Treatment of Elderly Intertrochanteric Fractures

2021 ◽  
Author(s):  
Wen-Bo Wei ◽  
Sha-Jie Dang ◽  
Ling Wei ◽  
MengXi Xin
Keyword(s):  
Postoperative Complications ◽  
Operation Time ◽  
The Elderly ◽  
Proximal Femoral Nail ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Hospitalization Time ◽  
Femoral Nail ◽  
Time Operation ◽  
Significant Difference

Abstract Background: Although proximal femoral nail anti-rotation (PFNA) and bipolar hemiarthroplasty (BHA) are selected by most of the orthopaedic surgeons for elderly intertrochanteric fractures (ITFs) patients, there is still no consensus on the superiority of PFNA and BPH for ITFs in the elderly. The study aims to compare the curative effects of proximal femoral nail anti-rotation (PFNA) and cementless bipolar hemiarthroplasty (BHA) on ITFs in the elderly. Methods: From January 2012 to December 2016, a total of 62 patients participated in the study: BHA (Group B, n=30), PFNA (Group P, n=32). The fractures were classified according to Evans-Jensen. Hospitalization time, operation time, bleeding loss, Harris scores and postoperative complications were compared between the two groups. Results: The operation time was (125.76 ± 33.49) min and (94.38 ± 20.94) min in PFNA group and BHA group (P < 0.05); bleeding loss was (153.33 ± 59.96) mL and (335.31 ± 90.87) mL(P < 0.05); hospitalization time was (17.13 ± 2.92) days and (16.63 ± 3.64) days (P > 0.05); and the Harris scores were (73.20 ± 6.56) points and (68.91 ± 8.15) points (P < 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). Conclusion: Both PFNA and BHA are safe and effective treatments for femoral intertrochanteric fractures in elderly patients. Nonetheless, BHA can be considered for those with the poor bone condition and short life expectancy.

scholarly journals A comparative study of Dynamic Hip Screw and Proximal Femoral Nail in the management of Intertrochanteric Fractures of the Femur

2021 ◽  
Vol 24 (1) ◽  
pp. 14-18
Author(s):  
Sandeep Gurung ◽  
Gopalsagar DC
Keyword(s):  
The Elderly ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Distinct Advantage ◽  
Unstable Fracture ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Clinical And Radiological Outcome ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture

Introduction: Intertrochanteric fractures account for approximately half of the hip fractures in the elderly because of the osteoporotic nature of the bone. There are various modalities to treat these fractures. The objective of this study was to compare and evaluate the clinical and radiological outcome of intertrochanteric femur fracture treated with Dynamic hip screw (DHS) and proximal femoral nail (PFN). Methods: This study was conducted at Nepalgunj medical college, Department of orthopedics Nepalgunj over a time span of two years. A total of 52 patients were included and randomized into Dynamic hip screw (n=26) and Proximal femoral nail (n=26) group. Patient’s demographic details, perioperative findings, radiological findings and follow up findings were recorded. The results were evaluated and compared. Results: The mean age in our study was 57.63 years. Trivial fall was the most common mode of injury. There was significantly higher intraoperative blood loss in the DHS group. Radiological union and functional outcomes were similar overall, but in case of unstable fracture functional outcome was clinically better in PFN group. Conclusion: From our study we concluded that PFN has better outcome in case of unstable intertrochanteric fractures, however in stable fracture also it has distinct advantage over DHS.

Proximal Femoral Nail for the Treatment of Reverse Obliquity Intertrochanteric Fractures Compared With Gamma Nail

2007 ◽  
Vol 63 (5) ◽  
pp. 1054-1060 ◽  
Author(s):  
Woo-Kie Min ◽  
Shin-Yoon Kim ◽  
Tae-Kong Kim ◽  
Kyu-Bong Lee ◽  
Myung-Rae Cho ◽  
...  
Keyword(s):  
Gamma Nail ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Femoral Nail

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

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

<p class="abstract"><strong>Background:</strong> 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<strong> </strong>to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.</p><p class="abstract"><strong>Methods:</strong> 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).<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Critical analysis of factors determining mechanical failures in proximal femoral nailing

2019 ◽  
Vol 5 (2) ◽  
pp. 275 ◽  
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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the patients<strong> </strong>33%<strong> </strong>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 (TAD<sub>AR </sub>-TAD<sub>LS</sub>) 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.</p><p class="abstract"><strong>Conclusions:</strong> From our study we like to conclude that the<strong> </strong>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.</p>

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

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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