Reduced complication rates for unstable trochanteric fractures managed with third-generation nails: Gamma 3 nail versus PFNA

Bonnaire, F.; Lein, T.; Fülling, Tim; Bula, P.

doi:10.1007/s00068-019-01200-7

Cited by 13 publications

(12 citation statements)

References 51 publications

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“…The forest plot of four outcomes indicated the two studied devices had no statistically significant difference. Eleven studies [7,[16][17][18][19][20][21][22][23][24][25] included a total of 1,146 patients concerned with mechanical failure rates, the quality of the evidence was moderate, as some articles [7,22,25] have a small sample size and there is a risk of bias (Figure 4). No significant differences were found in helical blade versus lag screw (OR=0.71, 95% CI 0.40-1.27, p=0.22; Figure 5).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Random-effect model was used to explore heterogeneity, I 2 =23%, and no statistically significant heterogeneity was found between these studies. Additionally, five of the studies [20][21][22][23][24] included a total of 642 patients concerned with the quality of reduction, the quality of the evidence was moderate, due to the exited inconsistency about the evaluation of reduction criteria (Figure 6). The excellent and good rate of fracture reduction was no significantly different between the helical blade and lag screw (OR=1.33, 95% CI 0.61-2.90, p=0.48; Figure 7).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

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Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Huang

Wei

2022

Jt Dis Relat Surg

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Currently, there are two surgical ways to treat intertrochanteric fractures among the elderly, including extramedullary or intramedullary fixation. [1,2] Although extramedullary fixation is the conventional treatment of intertrochanteric fractures, intramedullary fixation has become a more popular method with the development and progress of intramedullary instruments. [3] The optimal choice between the helical blade and lag screw is still controversial. [4][5][6] Some pieces of literature have reported that there is no difference in the clinical efficacy, excepted for the operation time that the lag screw is longer than that of the helical blade. [7] However, biomechanical studies have shown that the helical blade is superior to the conventional solid lag Objectives: In this review, we aimed to compare the radiological and functional outcomes between the helical blade and lag screw in treating intertrochanteric fractures among the elderly and to provide suggestions for clinical treatment. Materials and methods:Between January 1 st , 1990 and January 12 th , 2022, the literature search in document databases identified eligible randomized-controlled trials (RCT) studies directly comparing the helical blade and lag screws for treating hip fractures. The mechanical failure rates, the excellent and good rate of fracture reduction, Harris Hip Score (HHS), and postoperative hip pain of two intramedullary devices (helical blades versus lag screws) in patients with intertrochanteric fractures were analyzed using the RevMan software and Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The random-effects models were used for statistical analysis.Results: A total of 11 articles containing 1,146 patients for helical blade and lag screw comparison were included. Compared to the lag screws, the mechanical failure rate (odds ratio [OR]=0.71, 95% confidence interval [CI] 0.40-1.27, p=0.25), the excellent and good rate of fracture reduction (OR=1.33, 95% CI 0.61-2.90, p=0.48), HHS (mean differences 1.83, 95% CI -0.29-1.83, p=0.09), and postoperative hip pain (OR=0.41, 95% CI 0.14-1.21, p=0.11) were similar with the helical blades. There was no significant difference between the two implants in terms of the treatment outcomes. Conclusion:Both helical blades and lag screws are good choices for treating intertrochanteric fracture among elderly.

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Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Huang

Wei

2022

Jt Dis Relat Surg

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“…Osteosintezė intrameduline vinimi dažnai yra pagrindinė priemonė, užtikrinanti stabilią kaulo fiksaciją, ankstyvą galimybę minti operuota koja, ypač esant sudėtingiems, nestabiliems lūžiams. Sudėtingų tarpgūbrinės srities lūžių sintezė siejama su dažnomis mechaninė- [4,5]. Darbo tikslas -pristatyti ypač retą intraoperacinę komplikaciją -kelio sąnario penetraciją šlaunikaulio diafizės skeveldra intramedulinės osteosintezės metu.…”

Section: įVadasunclassified

Kelio Sąnario Penetracija Šlaunikaulio Diafizės Skeveldra Intramedulinės Osteosintezės Metu. Klinikinis Atvejis

Jodinskas¹,

Masionis²,

Porvaneckas³

et al. 2020

Health Sciences

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Šlaunikaulio artimojo galo lūžiai – dažna vyresnio amžiaus žmonių traumų pasekmė. Tik ankstyvas operacinis gydymas gali sumažinti komplikacijų riziką ir mirštamumą, tačiau kiekvienas gydymo metodas turi ne tik pranašumų, bet ir specifinių komplikacijų. Straipsnyje pristatomas ypač retos intraoperacinės komplikacijos klinikinis atvejis – kelio sąnario penetracija šlaunikaulio diafizės skeveldra intramedulinės osteosintezės metu. Ši komplikacija labai reta, o įvykusi – pavėluotai diagnozuojama. Atvejo analizės rezultatai parodė, kad intramedulinės osteositnezės, atliekamos rentgeno kontrolėje, metu būtina nuodugniai įvertinti ne tik lūžgalių ir konstrukcijų padėtis, bet ir šalia esančius sąnarius.

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“…Over the past decade, intramedullary nailing (IMN) has become the preferred treatment method in tibial, femoral shaft, and sub-or intertrochanteric fractures [1][2][3][4]. Despite good results, a number of complications are described: rotational and axial malalignment, shortening of the limb, intraoperative fracture, hardware breakage, joint penetration by guidewire or nail, malunion, nonunion, infection, and neurovascular damage [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

Masionis¹,

Porvaneckas²,

Uvarovas³

et al. 2022

Cureus

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Intramedullary nailing is the preferred treatment method in tibial, femoral shaft, and sub-or intertrochanteric fractures. Despite good results, a number of complications have been well-characterized. Joint perforation by bone fragment during nail insertion is one such complication.We report an eventful case of a 63-year-old female patient who presented with an intertrochanteric fracture. Osteosynthesis with a short proximal femoral nail was complicated by a well-known and recognized on-time complication -an iatrogenic fracture of the femoral shaft. However, it was further complicated by knee arthrodesis by a bone fragment when a long nail was inserted. The bone fragment not only "closed" the knee joint, but fractured the medial tibial condyle and protruded into the medial soft tissues of the joint. This misfortune was not recognized intraoperatively and led to revision surgery in the short term and joint posttraumatic arthrosis with resultant total knee replacement in the long term.

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Reduced complication rates for unstable trochanteric fractures managed with third-generation nails: Gamma 3 nail versus PFNA

Cited by 13 publications

References 51 publications

Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Kelio Sąnario Penetracija Šlaunikaulio Diafizės Skeveldra Intramedulinės Osteosintezės Metu. Klinikinis Atvejis

From Bad to Disaster: Iatrogenic Fracture Followed by Knee Perforation With Bone Fragments During Femoral Nailing

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