Biomechanical Evaluation of the Proximal Femoral Nail

Schipper, I.B.; Bresina, Stephen; Wahl, D.; Linke, Berend; Vugt, A.B. van; Schneider, Erich

doi:10.1097/00003086-200212000-00035

Cited by 56 publications

(55 citation statements)

References 2 publications

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“…When the hip pin was 10 mm shorter than the lag screw, the percentage of the total load carried by the hip pin ranged from 8 to 39% (mean, 21%) 18 ; no cut-out of the femoral head and no unacceptable implant or fracture displacement were observed. 8 In our study, the hip pin was 10 to 15 mm shorter than the lag screw, and this may have prevented overloading the hip pin and cut-out in all cases. Unstable A2 fractures should be initially reduced to a slightly valgus position during PFN surgery, because the neck-shaft angle would decrease during the first 6 postoperative weeks.…”

Section: Discussionmentioning

confidence: 67%

Proximal Femoral Nail for Treatment of Trochanteric Femoral Fractures

Morihara

Arai

Tokugawa

et al. 2007

J Orthop Surg (Hong Kong)

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Purpose. To report outcomes of 87 consecutive patients treated with a proximal femoral nail (PFN) for trochanteric femoral fractures. Methods. 17 men and 70 women aged 58 to 95 (mean, 85) years with trochanteric femoral fractures underwent PFN fixation using an intramedullary nail, a lag screw, and a hip pin. Fractures were classified according to the AO system; the most common fracture type was A2 (n=45), followed by A1 (n=36) and A3 (n=6). The position of the lag screw within the femoral head was measured. The lateral slide of the lag screw after fracture consolidation was measured by comparing the immediate postoperative and final anteroposterior radiographs. Results. 90% of lag screws were placed in an optimal position. The length of lateral slide of the lag screw in stable A1 fractures was significantly less than that in unstable A2 fractures; it was over 10 mm in 7 of 45 patients with A2 fractures. Cut-out of lag screw did not occur, suggesting that free sliding of the lag screw facilitates direct impaction between fragments. Conclusion. A PFN is useful for the treatment of trochanteric femoral fractures.

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Section: Discussionmentioning

confidence: 67%

Proximal Femoral Nail for Treatment of Trochanteric Femoral Fractures

Morihara

Arai

Tokugawa

et al. 2007

J Orthop Surg (Hong Kong)

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“…Although complication rates remain low, cut-out of either screw is a serious complication, which can lead to revision surgery and related morbidity. When the hip pin was 10mm shorter than lag screw, the percentage of the total load carried by the hip pin ranged from 8-39% (mean 21%) [11,12] . Unstable A2 fractures should be initially reduced to a slightly valgus position during PFN surgery, because the neck-shaft angle would decrease during the first 6 postoperative weeks.…”

Section: Discussionmentioning

confidence: 99%

Study of clinical and functional outcomes of unstable intertrochanteric femur fractures treated with long proximal femoral nail

Shah¹,

Rathod²

2018

Int. J. Orthop. Sci.

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Introduction:The following study was conducted to examine the long term clinical, radiological and functional results of unstable intertrochanteric femur fractures treated with long Proximal Femoral Nail. Materials and Methods: This was a prospective, non-randomized study of 50 cases of intertrochanteric fractures of unstable variety treated by long Proximal Femoral Nail at the Department of Orthopedics, B J Medical College and Civil Hospital, Ahmedabad, between 2014 to 2016. Patients were undergoing primary surgery, with unstable types of fracture pattern AO/OTA type 31A2.2 to 31A3.3. Pathological fractures and patients with previous surgery on proximal femur were excluded. Results: The sample consisted fifty patients, 33 were males and 17 females. The patients' ages ranged from 18 -90 years with mean of 68.2 years. Majority (86%) of the intertrochanteric fractures occurred following trivial trauma usually a domestic accident like fall in bathroom or fall from stairs. Associated bony injuries were present in 3 cases (6%). Most common associated injury was fracture lower end radius (in all 3 cases). 29(58%) patients had an osteoporosis Grade 5 while 17 (34%) had Grade 4. AO/OTA Type A2.3 type of fractures were most common in 31 (62%) patients, followed by A2.2, A3.1 and A3.3. Functional Outcome was assessed with modified Harris Hip Score in which 70% of the patients had good to excellent functional results on final follow up at 1 year. Conclusion:The proximal femoral nail, is an optimum implant for the internal fixation of unstable intertrochanteric fractures with advantages of stable fixation, perfect reduction, early weight bearing and ambulation, shortened hospital stay and improved rate of union with early resumption of independent life style.

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“…Incidence of cut-out of lag screw is controversial because many authors have reported cut-out more with DHS while others have reported it more with the PFN. Schipper et al [18] have reported a cut out rate of 6.6% with gamma nail and 6.9% with PFN. Simmermacher et al [16] have not reported any case of post operative of later fracture of femur with DHS while Radford et al [29] have shown fracture in 1.0% operative fracture of femur and 3.0% cut out with DHS.…”

Section: Resultsmentioning

confidence: 97%

Untitled

2017

Int. J. Orthop. Sci.

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Introduction: Proximal Femoral fracture is one of the most devastating injuries in orthopaedic traumatology. In the past, these injuries were commonly noted in elderly person. With the industrial development, these injuries have become more common in young adults. This is mostly high velocity trauma and leads to unstable proximal femoral fracture. This has become a challenging fractures to treatment among the orthopaedic surgeons now a days Material and Method: My purpose to conduct a non randomized prospective study of the Role of Proximal Femoral nail in 50 adults with unstable Proximal Femoral Fractures. This study were be conducted in the Department of Orthopaedics PCMS, Bhopal. Result: One the basis of Haris Hip score functional assessment, at 1 year 33(66%) patients showed excellent results while 13(26%) patients showed good, 2(4%) patents fair, 2(4%) patients poor. Conclusion: Surgeon may treat the demanding unstable proximal femoral fracture with any type of fixation device as long as He/ She remembered that the fixation device will never make up for surgical failure. Therefore improvement in the treatment of unstable proximal femoral fracture were predominantly in the hands of the surgeon rather than in the hands of industries.

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Biomechanical Evaluation of the Proximal Femoral Nail

Cited by 56 publications

References 2 publications

Proximal Femoral Nail for Treatment of Trochanteric Femoral Fractures

Proximal Femoral Nail for Treatment of Trochanteric Femoral Fractures

Study of clinical and functional outcomes of unstable intertrochanteric femur fractures treated with long proximal femoral nail

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