Long proximal femoral nails versus short proximal femoral nails for the management of proximal femoral fractures: a retrospective study of 124 patients

Parmar, Dipak S.; Porecha, Milind M.; Chudasama, S.L.

doi:10.1007/s00590-010-0683-8

Cited by 8 publications

(22 citation statements)

References 25 publications

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“…The studies were all published over a six-year period between 2010 and 2016. The largest sample size, and most recent, was Lindvall et al 8 with 611 patients and the lowest sample size (and oldest) was Parmar et al 9 with 134 patients. All studies examined Orthopaedic Trauma Association (OTA) 31 -A1/A2 type fractures.…”

Section: Resultsmentioning

confidence: 99%

“…Lindvall et al, 8 Li et al 10 and Kleweno et al 11 also included OTA 31 -A3 type fractures. In addition to this, Vaughn et al 12 included OTA 32 -A1/A2/A3 type fractures and furthermore Parmar et al 9 also looked at OTA 33 -A1/A2/A3 type fractures. Lindvall et al 8 and Vaughn et al 12 also commented on the implication of locking of the nails; however, this was not covered in great depth and the question of whether IM devices should be locked is not within the remit of this review.…”

Section: Resultsmentioning

confidence: 99%

“…Of the nine papers, five analysed blood loss with the recorded values ranging from 69.95 ml to 250 ml for the short nail and 77.97 ml to 250 ml for the long nail. [8][9][10]13,14 Three of the five papers identified a statistically significant difference between blood loss between the short and the long nails with reduced blood loss when using the short nail. 10,13,14 Lindvall et al 8 reported that there was less blood loss for the short nail, but that this was not statistically significant whereas Parmar et al 9 showed no difference in blood loss between the two groups.…”

Section: Blood Loss and Transfusion Requirementmentioning

confidence: 99%

“…Eight studies examined the operative time which ranged from 41 to 70 min for the short nail and 53.7-71.8 min for the long nail [8][9][10][11]13,14,16 with six papers finding the short nail to be significantly quicker 10,11,[13][14][15][16] ; Lindvall et al 8 found the short nail to be quicker but not significantly so and Parmar et al, 9 actually found the long nail to be quicker by one minute, but this was not highlighted as significant. The combined data show a statistically significant difference in operative time in favour of the short nail being quicker (50.57 vs. 62.68 mins; p ¼ 0.004).…”

Section: Operative Timementioning

confidence: 99%

“…Length of stay (LOS) was recorded by five papers 9,[13][14][15][16] and all had less than 24 h difference between groups with three showing short nails had shorter LOS 9,14,15 and two longer, 13,16 meaning that there was no individual statistically significant difference nor when the data are pooled.…”

Section: Length Of Staymentioning

confidence: 99%

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A systematic review of short versus long intramedullary fixation in the management of pertrochanteric fractures

Sohatee

2017

Trauma

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Introduction: The aim was to determine whether there is a significant difference in clinical outcomes when using short vs. long nails for pertrochanteric femur fractures. Methods: A systematic literature search was undertaken of Pubmed and Embase in April 2016. All papers published in English reporting studies comparing long vs. short nails for pertrochanteric femur fractures were studied. Data were pooled for blood loss and transfusion requirement, operative time, length of stay, incidence of delayed or non-union, incidence of avascular necrosis or infection, fracture or metalware failure and was analysed to examine the differences between long and short nails. Results: From 90 potential studies, nine were considered to be eligible for inclusion. The short nail resulted in a statistically significant benefit when looking at transfusion requirement (p ¼ 0.02); however, blood loss was not statistically different (p ¼ 0.33) Operative time was also quicker with the short nail (p ¼ 0.004), but the length of stay was no different (p ¼ 0.41). When examining complications and fixation outcomes, there was no difference in delayed union rates (p ¼ 0.29) and non-union rates (p ¼ 0.19) nor when looking at metalware failure (p ¼ 0.41) and fracture (p ¼ 0.14). Discussion: The use of short intramedullary nails for pertrochanteric femur fractures appeared to be beneficial when looking at transfusion requirements and operative time. When looking at complications such as fracture and metalware failure, despite there being a slightly higher incidence of these in the short nail group, it is not statistically significant. This study advocates that both devices are safe to use, however, the short nail may have some perceived benefits in reducing transfusion requirements and have cost benefits with a shorter operative time.

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Section: Resultsmentioning

confidence: 99%