Geometric Mismatch of the Gamma Nail to the Chinese Femur

Leung, Kcm; Procter, Philip; Robioneck, Bernd; Behrens, Katharina

doi:10.1097/00003086-199602000-00006

Cited by 77 publications

(43 citation statements)

References 7 publications

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“…In our series, 11 cases of mismatch between the proximal end of the nail and proximal femur were encountered in the short elderly patients. As the height in a Chinese population on average is less than that of Europeans and Americans, the proximal femoral length and femoral neck diameter are relatively shorter [11]. When the PFNA was used in short elderly Chinese patients, the length of the proximal end of the nail proved to be too long, resulting in inappropriate placement of the spiral blade or redundancy of the proximal end of the nail.…”

Section: Discussionmentioning

confidence: 99%

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Results of the proximal femoral nail anti-rotation (PFNA) in elderly Chinese patients

Jin-song

Лю

Wang

et al. 2009

International Orthopaedics (SICOT)

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A prospective study is presented of 87 unstable intertrochanteric fractures treated with the proximal femoral nail anti-rotation (PFNA) with a follow-up of one year. Of the patients 76% were female. The average age was 75.3 years. The fracture was treated by closed reduction and intramedullary fixation. Pre-injury activity level was recovered in 77% of the patients. Fractures united in all patients. Mechanical failure and cut-out were not observed. A technical problem related to the mismatch of the proximal end of the nail was observed in 11 cases. Nine patients presented with thigh pain due to the redundant proximal end of the nail. The results of the PFNA were satisfactory in most elderly Chinese patients. However, the proximal end of the nail was not matched with the specific anatomy of some short elderly patients. Further modifications of the nail are necessary for the elderly Chinese population.

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Section: Discussionmentioning

confidence: 99%

“…Leung et al [11] reported the geometric mismatch between the gamma nail and the Chinese femur. A relatively shorter femur and excessive anterior bowing in the older Chinese population lead to the tip of the standard nail or even the shortest nail usually passing beyond the most convex part of the anterior bow.…”

Section: Discussionmentioning

confidence: 99%

Results of the proximal femoral nail anti-rotation (PFNA) in elderly Chinese patients

Jin-song

Лю

Wang

et al. 2009

International Orthopaedics (SICOT)

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“…But they are associated with intra-operative technical and mechanical complications [9,10]. Moreover, geometrical mismatch between proximal femoral nail and the femora of Asians make surgery more difficult and complicated [11,12].…”

Section: Introductionmentioning

confidence: 99%

Proximal femoral nails compared with reverse distal femoral locking plates in intertrochanteric fractures with a compromised lateral wall; a randomised controlled trial

Haq

Manhas

Pankaj

et al. 2014

International Orthopaedics (SICOT)

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Purpose There is no consensus about the best option of internal fixation for unstable intertrochanteric fractures. The aim of the present study was to compare proximal femoral nail (PFN) with contralateral reverse distal femoral locking compression plate (reverse-DFLCP) in the management of unstable intertrochanteric fractures with compromised lateral wall. Method In a randomized controlled study, from November 2011 to October 2012, 40 patients with unstable intertrochanteric fractures with compromised lateral wall (AO 31A 2.2 to 3.3) had osteosynthesis by PFN (n=20) or reverse-DFLCP (n=20). Intraoperative variables compared were duration of surgery, blood loss during surgery, fluoroscopy time and surgeons perception of the surgery. Patients were followed up clinically for a minimum of one year. Functional outcome was assessed by Parker Palmer mobility score (PPMS), Harris hip score (HHS), and Short Form-12. Failure was defined as any condition which would necessitate revision surgery with change of implant. Results Duration of surgery (p=0.022), blood loss during surgery (p=0.008) and fluoroscopy time (p=0.0001) were significantly less in the PFN group than in the reverse-DFLCP group. No significant difference was found in type of reduction, difficulty in reduction and surgeon's perception of surgery. The PFN group had better functional outcome than the reverse-DFLCP group. HHS for the PFN group was 81.53±13.21 and for the reverse-DFLCP group it was 68.43±14.36 (p=0.018). SF-12 physical (p=0.002) and mental component (p=0.007) scores in the PFN group was significantly better than in the reverse-DFLCP group. There was one failure in the PFN group as compared to six in the reverse-DFLCP group (p=0.036). Conclusion Due to favourable intra-operative variables, better functional outcome and lower failure rates, we conclude that PFN is a better implant than reverse-DFLCP for intertrochanteric fractures with compromised lateral wall.

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“…Implants that are designed by taking in to account anthropometric and bio mechanic data will help in designing patient specific implants thereby minimizing the complications [21]. Numerous studies have also shown that there is increase in the rate of intraoperative complication in the event of using mismatched implants especially over size implants [19].…”

Section: Resultsmentioning

confidence: 99%