Results and complications of pertrochanteric hip fractures using an intramedullary nail with a helical blade (proximal femoral nail antirotation) in 200 patients

Aguado-Maestro, I.; Escudero-Marcos, R.; García-García, J.M.; Alonso-García, Noelia; Pérez-Bermejo, D.; Aguado-Hernández, H.J.; Nistal, Raúl; García-Alonso, Manuel

doi:10.1016/j.recote.2013.03.005

Cited by 18 publications

(30 citation statements)

References 25 publications

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“…Incidence of secondary lateral wall fractures is higher than primary lateral wall fractures. 2,9,17 Our series revealed similar picture. In our study, 12/40 (30%) had lateral wall fractures.…”

Section: Discussionsupporting

confidence: 81%

“…In correlation to similar studies with larger sample size, there is no significant correlation between sex and outcome of fracture. 9,12,19 The average duration of surgery was 43 minutes and it did not correlate to final outcome. 2 These results are comparable to other studies.…”

Section: Discussionmentioning

confidence: 92%

“…It should be <4 mm. 4,7,9,11 In my study, displacement was the gap measured at posteromedial cortex in antero-posterior view of X-ray.…”

Section: Displacementmentioning

confidence: 91%

“…6,8,10 A tip apex distance <25 mm is protective of the screw cutting out of the femoral head. 6,[8][9][10]12 Baumgaertner et al first time described how to correctly measure on x ray film by taking magnification into consideration. Position of screw away from centre increases tip apex distance.…”

Section: Tip Apex Distancementioning

confidence: 99%

“…7,8,10 Position of lag screw It is described by Cleveland and Bosworth method of nine Quadrants. 6,[8][9][10]11 For this both AP and translateral X-ray views of hip joint are required.…”

Section: Tip Apex Distancementioning

confidence: 99%

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Prospective study of prognosis of intertrochanteric fractures with lateral wall involvement as compared to intertrochanteric fractures with intact lateral wall

Bansal

2019

Int J Res Orthop

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Background: Intertrochanteric fractures with fracture lateral wall (FLW) are biomechanically unstable fractures.Methods: 40 patients who met inclusion criteria underwent surgery. Post-operatively patients were followed up for a minimum period of 24 weeks. Radiological and functional assessment was done post-operatively. Endpoints of fracture were studied thoroughly.Results: Secondary lateral wall fractures were common than primary lateral wall fractures. Functional outcome was found to be poor in FLW than intact lateral wall (ILW) group (p=0.01). HHS of ILW fracture was 70, while in FLW it was 46. Displacement was found to be a better radiological parameter to assess reduction quality (p=0.02) than neck shaft angle. Implant position with Cleveland method was found to be a better predictor of fixation quality than tip apex distance. There were 6 (15%) mechanical failures. Screw cut out (3 cases) found to be most common mechanical complication (7.5%). There were four failures (33%) in FLW. Secondary lateral wall fractures were found to have poor prognosis than primary lateral wall fractures. A2.3 was found to have more chance of conversion to A3 due to thinned out lateral wall. Many of them happened when DHS was the implant of choice (60%).Conclusions: Functional outcome of FLW is poor than ILW. Secondary lateral wall fractures have worse prognosis than primary lateral wall fractures. Fragment specific fixation is difficult in secondary lateral wall fractures as compare to primary lateral wall fracture, due to higher comminution.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 92%

“…It should be <4 mm. 4,7,9,11 In my study, displacement was the gap measured at posteromedial cortex in antero-posterior view of X-ray.…”

Section: Displacementmentioning

confidence: 91%

Section: Tip Apex Distancementioning

confidence: 99%

“…7,8,10 Position of lag screw It is described by Cleveland and Bosworth method of nine Quadrants. 6,[8][9][10]11 For this both AP and translateral X-ray views of hip joint are required.…”

Section: Tip Apex Distancementioning

confidence: 99%

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Prospective study of prognosis of intertrochanteric fractures with lateral wall involvement as compared to intertrochanteric fractures with intact lateral wall

Bansal

2019

Int J Res Orthop

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How much of the superolateral femoral neck should be removed in intramedullary nail fixation for intertrochanteric fracture?

Li,

et al. 2023

Journal Orthopaedic Research

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PurposeThe objective of this study was to measure how much of the superolateral femoral neck should be removed to reduce the incidence of wedge effect.MethodsSimulating Surgery: Computed Tomography images of 131 intertrochanteric fracture patients were included, three‐dimensionally reconstructed, virtually reduced and implanted with PFNA‐Ⅱ nail. The antero‐posterior length and media‐lateral width of the intersection between superolateral femoral neck and PFNA‐Ⅱ nail were measured. Retrospective study: The pre‐ and post‐operative CT of 30 patients were collected. The average varus angle of the neck‐shaft angle and the correlation between the angles and the difference in the actual and estimated width of the fragments removed were measured.ResultsModels of 108 patient were selected for analysis. The average antero‐posterior length and media‐lateral width were 14.46mm (14.00mm‐14.93mm) and 9.33mm (8.79mm‐9.87mm) respectively. The AO/OTA classification was not significantly associated with the outcome, but the gender was. In the retrospective study, the mean value of the varus angles was ‐4.58° (SE=6.85°), and the difference of width was strongly positively correlated with the varus angle with a correlation coefficient of 0.698.ConclusionsResults obtained in this study can improve the understanding of this region and help surgeons to make appropriate pre‐operative planning to reduce the incidence of wedge effect. Retrospective study provided effective proof of the reliability of this study.This article is protected by copyright. All rights reserved.

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Cemented hip hemiarthroplasty clinical observations on unstable intertrochanteric fracture in elderlies

Qiu

Liu

et al. 2015

Eur J Trauma Emerg Surg

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Results and complications of pertrochanteric hip fractures using an intramedullary nail with a helical blade (proximal femoral nail antirotation) in 200 patients

Cited by 18 publications

References 25 publications

Prospective study of prognosis of intertrochanteric fractures with lateral wall involvement as compared to intertrochanteric fractures with intact lateral wall

Prospective study of prognosis of intertrochanteric fractures with lateral wall involvement as compared to intertrochanteric fractures with intact lateral wall

How much of the superolateral femoral neck should be removed in intramedullary nail fixation for intertrochanteric fracture?

Cemented hip hemiarthroplasty clinical observations on unstable intertrochanteric fracture in elderlies

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