Intramedullary Fixation of Unstable Intertrochanteric Hip Fractures

Kubiak, Erik N.; Bong, Mathew; Park, Samuel S.; Kummer, F; Egol, Kenneth A.; Koval, Kenneth J.

doi:10.1097/00005131-200401000-00003

Cited by 87 publications

(58 citation statements)

References 25 publications

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“…Due to the smaller diameter lag screws in these intramedullary nails, the proximal aspects of the nail do not need to be flared to prevent mechanical failure of the nail and hence requires less reaming of the proximal femur, thereby reducing the risk of iatrogenic proximal femoral fracture. 7 In our study, both intra-operatively and postoperatively, there were no instances of femoral shaft fractures or extension of the original fracture. This was similar to the findings of Saudan et al 2 in their series.…”

Section: Discussionmentioning

confidence: 42%

A Comparative Study of Functional Outcome Between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Management of Per - Trochanteric Fractures

Shivanna¹,

Rudrappa²

2015

jemds

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BACKGROUND:The choice of implant between the extramedullary Dynamic Hip Screw (DHS) and intramedullary Proximal Femoral Nail (PFN) in the surgical management of pertrochanteric fractures is still an enigma. Various meta-analysis conducted so far have yield conflicting results. METHODS: Prospective randomized controlled study including 30 patients with 30 pertrochanteric fractures out of which 15 were treated with DHS and 15 with PFN. RESULTS: The overall functional outcome of patients treated with the PFN was significantly better than those treated with DHS (p<0.037), especially in patients with unstable fractures. Other advantages of PFN included smaller incisions, shorter operative times, relatively less blood loss and less postoperative pain and early ambulation. CONCLUSION: We conclude that in stable intertrochanteric fractures, both the PFN and DHS have similar outcomes. However, in unstable intertrochanteric fractures the PFN has significantly better outcomes in terms of earlier restoration of walking ability and less limb length shortening.

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Section: Discussionmentioning

confidence: 42%

A Comparative Study of Functional Outcome Between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Management of Per - Trochanteric Fractures

Shivanna¹,

Rudrappa²

2015

jemds

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“…Femoral neck fractures are very rare in young individuals with normal bone and are common in older patients with osteoporosis [28][29][30][31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

A three-year follow-up on injuries sustained by cruise ship passengers and crew treated at the Orthopaedic and Traumatology Department at Dubrovnik County Hospital

Bekić

Mikolaučić

Golubovic

et al. 2015

Injury

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“…13,17,18 But we believe that this situation doesn't simulate the real stance. Because load to failure under such a condition eventually leads a failure from femoral head.…”

Section: Resultsmentioning

confidence: 93%

A biomechanical comparison of two cephalomedullary nails; one using a single lag screw with antirotator blade and a nail using two lag screws for unstable intertrochanteric fractures

et al. 2016

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Background: Implant choice for fixation of intertrochanteric fractures remains controversial despite being one of the most commonly performed operations. Although use of sliding hip screws is still considered a gold standard in treatment of these fractures, there is a wide tendency in using cephalomedullary nails because of their biomechanical superiority over sliding hip screws. This trial was initiated in order to compare the biomechanical properties of two different cephalomedullary nails, aPFN and the PROFIN under axial loading, based on the questions that can a single lag screw with an antirotator blade render better rotational stability? Is there a difference between one lag screw or two lag screws with respect to superior migration or cut-out of the screws? And do different nail designs cause different types of failure and what are the pros and cons of classical and new designs from the view point of biomechanical aspects?Methods: Ten pairs of third generation synthetic bone models simulating unstable intertrochanteric fracture were used for biomechanical testing.Results: No posterior displacement of screws was recorded in both groups suggesting rotational unstability. There was not a significant difference between forces values loaded at the time of failure.Conclusions: Although there was no statistically significant difference between compressive strengths at the time of failure, aPFN may provide equal rigid fixation with less possible cut-out which may have an important consequences in real clinical applications.

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Intramedullary Fixation of Unstable Intertrochanteric Hip Fractures

Abstract: The two constructs showed equivalent rigidity and stability in all parameters assessed in elastic and cyclical tests. The TAN had a greater ultimate failure load.

Cited by 87 publications

References 25 publications

A Comparative Study of Functional Outcome Between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Management of Per - Trochanteric Fractures

A Comparative Study of Functional Outcome Between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Management of Per - Trochanteric Fractures

A three-year follow-up on injuries sustained by cruise ship passengers and crew treated at the Orthopaedic and Traumatology Department at Dubrovnik County Hospital

A biomechanical comparison of two cephalomedullary nails; one using a single lag screw with antirotator blade and a nail using two lag screws for unstable intertrochanteric fractures

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