Peri-implant femoral fractures: The risk is more than three times higher within PFN compared with DHS

Müller, Franz; Galler, Michael A.; Zellner, Michael; Bäuml, Christian; Marzouk, Ashraf; Füchtmeier, Bernd

doi:10.1016/j.injury.2016.04.042

Cited by 35 publications

(16 citation statements)

References 6 publications

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“…14,24 However, five of six PPFs occurred after a fall from standing height, raising the question of whether these events represent a complication per se or a new entity. We did not find significant evidence of a relation between PPF and preexisting screw holes of the initial hardware within the proximal femoral cortex in a present study of peri-implant femoral fractures 8 but cannot exclude this possibility from the present study because of the small number of cases.…”

Section: Discussioncontrasting

confidence: 69%

“…[1][2][3][4] Research have reported conflicting results, with no device demonstrating clear benefit. [3][4][5][6][7][8] Moreover, treatment of proximal femoral fracture is associated with high complication rates (up to 35%) due to multifactorial and often patient-related factors as well as fracture etiology. 3,9,10 Osteosynthesis failure is considered a major complication, which necessitates changing or replacing the device to prevent further complications.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Total hip arthroplasty after failed osteosynthesis of proximal femoral fractures: Revision and mortality of 80 patients

Müller

Galler

Zellner

et al. 2017

Journal of Orthopaedic Surgery

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Section: Discussioncontrasting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Total hip arthroplasty after failed osteosynthesis of proximal femoral fractures: Revision and mortality of 80 patients

Müller

Galler

Zellner

et al. 2017

Journal of Orthopaedic Surgery

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“…3 It is seen with both dynamic hip screw (DHS) and proximal femoral nail (PFN). 10,11 The modes of failure as reported in literature 6,12 –16 were observed in our study, in addition we had a case of early postop dislocation which has no mention in previous studies. A multicenter study demonstrating high complication rates following re-osteosynthesis recommended THR as the only valid salvage procedure for failed proximal femur fixation.…”

Section: Discussionsupporting

confidence: 53%

Dual mobility total hip arthroplasty for salvaging failed internal fixation for neck of femur fractures

Luthra

Ghannami

Habsi

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Internal fixation is commonly used to treat fractures in the hip. However, failure of proximal femoral fracture fixation is common and treated with total hip replacement (THR). The aim of this study is to present our midterm results of dual mobility (DM) THR for failed internal fixation of proximal femur fractures. Between 2010 and 2015, a total of 28 cases of failed internal fixation for hip fractures were treated through DM total hip arthroplasty. Two patients died during the early postoperative period due to medical complications. The average follow-up was 3.4 years. We had one patient with superficial surgical site infection which was managed by local wound debridement and dressings. The average Harris hip score was 85. DM THR is the procedure of choice for revising failed internal fixation for hip fractures in our patients with good clinical outcome.

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“…11 there are still reports describing higher risk of periimplant fracture with imn than shs. 12 in this study, based on data from the norwegian hip fracture register (nhfr) from 2013 to 2019, we compared reoperation rates between shs and imn in stable fractures (ao/ota a1) and unstable fractures (ao/ota a2, a3, and subtrochanteric combined) one and three years postoperatively. secondary aims were to compare reoperation rates between shs and imn in a2, a3, and subtrochanteric fractures separately, and to compare mortality and patient-reported outcomes after shs and imn for stable and unstable fractures one year after surgery.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary nail versus sliding hip screw for stable and unstable trochanteric and subtrochanteric fractures

Grønhaug

Dybvik

Matre

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to investigate if there are differences in outcome between sliding hip screws (SHSs) and intramedullary nails (IMNs) with regard to fracture stability. Methods We assessed data from 17,341 patients with trochanteric or subtrochanteric fractures treated with SHS or IMN in the Norwegian Hip Fracture Register from 2013 to 2019. Primary outcome measures were reoperations for stable fractures (AO Foundation/Orthopaedic Trauma Association (AO/OTA) type A1) and unstable fractures (AO/OTA type A2, A3, and subtrochanteric fractures). Secondary outcome measures were reoperations for A2, A3, and subtrochanteric fractures individually, one-year mortality, quality of life (EuroQol five-dimension three-level index score), pain (visual analogue scale (VAS)), and satisfaction (VAS) for stable and unstable fractures. Hazard rate ratios (HRRs) for reoperation were calculated using Cox regression analysis with adjustments for age, sex, and American Society of Anesthesiologists score. Results Reoperation rate was lower after surgery with IMN for unstable fractures one year (HRR 0.82, 95% confidence interval (CI) 0.70 to 0.97; p = 0.022) and three years postoperatively (HRR 0.86, 95% CI 0.74 to 0.99; p = 0.036), compared with SHS. For individual fracture types, no clinically significant differences were found. Lower one-year mortality was found for IMN compared with SHS for stable fractures (HRR 0.87; 95% CI 0.78 to 0.96; p = 0.007), and unstable fractures (HRR 0.91, 95% CI 0.84 to 0.98; p = 0.014). Conclusion This national register-based study indicates a lower reoperation rate for IMN than SHS for unstable trochanteric and subtrochanteric fractures, but not for stable fractures or individual fracture types. The choice of implant may not be decisive to the outcome of treatment for stable trochanteric fractures in terms of reoperation rate. One-year mortality rate for unstable and stable fractures was lower in patients treated with IMN. Cite this article: Bone Joint J 2022;104-B(2):274–282.

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Peri-implant femoral fractures: The risk is more than three times higher within PFN compared with DHS

Cited by 35 publications

References 6 publications

Total hip arthroplasty after failed osteosynthesis of proximal femoral fractures: Revision and mortality of 80 patients

Total hip arthroplasty after failed osteosynthesis of proximal femoral fractures: Revision and mortality of 80 patients

Dual mobility total hip arthroplasty for salvaging failed internal fixation for neck of femur fractures

Intramedullary nail versus sliding hip screw for stable and unstable trochanteric and subtrochanteric fractures

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