The new proximal femoral nail antirotation (PFNA®) in daily practice: Results of a multicentre clinical study

Simmermacher, R. K. J.; Ljungqvist, J.; Bail, Hermann Josef; Hockertz, Thomas; Vochteloo, Anne J. H.; Ochs, U.; Werken, Chr. van der

doi:10.1016/j.injury.2008.02.005

Cited by 300 publications

(277 citation statements)

References 16 publications

Supporting

Mentioning

217

Contrasting

Unclassified

Order By: Relevance

“…This is an acceptable rate compared with other reports in the literature. 8,9 We did not find any cut-out or cutting through of the blade, unexpected blade migration and loosening of the blade. Implantrelated complications in proximal femoral fractures needing revision surgery, such as a cut-out of the implant through the femoral head, are reported to be as high as 16%.…”

Section: Discussionmentioning

confidence: 74%

“…In this context, we have to note that the mean age of our study population was 84.5 years and these patients have many co-morbid conditions. [40][41][42][43] These co-morbidities influence the recovery of the patients 41 and compared with the literature, [7][8][9] this is a satisfying outcome.…”

Section: Discussionmentioning

confidence: 88%

“…[7][8][9]37 Nevertheless, there are complications such as cutting out of the femoral head or blade loosening reported in the literature. [7][8][9] All these complications are catastrophic failures for these patients due to the necessity of reoperation. As most of these fractures occur in the elderly, these failures are even more severe due to the patients' co-morbidities and their inability to counterbalance, which comes along with a high perioperative morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The indication for the augmentation is not clear yet and we support the opinion that the good results with the PFNA in previous studies result from achieving a good fracture reduction and careful implant placement. 7,8,48 We think that a severe osteoporosis could be a possible indication but there are probably more concomitant patient-related factors to be considered. From the socioeconomic perspective also, additional costs have to be mentioned.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Standardised cement augmentation of the PFNA using a perforated blade: A new technique and preliminary clinical results. A prospective multicentre trial

Kammerlander

Gebhard

Meier

et al. 2011

Injury

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Standardised cement augmentation of the PFNA using a perforated blade: A new technique and preliminary clinical results. A prospective multicentre trial

Kammerlander

Gebhard

Meier

et al. 2011

Injury

View full text Add to dashboard Cite

“…After 2000's proximal femoral nails have been revised and, because of their biomechanical advantages, preferred very commonly especially in the unstable hip fractures with medial calcar discontinuity. However studies reporting complications related with this technique started to come out with the common use of these implants (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Reported complications are cut-out, medial migration of the lag screw, perforation of the femoral head, malunion in varus position, nonunion, avascular necrosis, implant failure, neurovascular injuries and stress fracture distal to the nail.…”

Section: Discussionmentioning

confidence: 99%

Pelvic Migration of Lag Screw Following Fixation of an Intertrochanteric Femur Fracture with Proximal Femoral Nail

Akçay¹,

Satoğlu²,

Çabuk³

et al. 2013

JAREM

View full text Add to dashboard Cite

Intertrochanteric femur fractures are very common in patients over 65 years old who have prominent osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures especially if the fracture is unstable with medial calcar discontinuity. However, many complications associated with intramedullary fracture fixation have been described following common use of these implants. Here, we report a rare complication of a short intramedullary nail in which medial pelvic migration of the lag screw was detected at eighth week postoperatively. The patient was subsequently treated with lag screw removal. (JAREM 2013; 3: 44-6)

show abstract

Cement augmentation of hip implants in osteoporotic bone: How much cement is needed and where should it go?

et al. 2013

View full text Add to dashboard Cite

Several studies proved the beneficial effect of cement augmentation of proximal femoral nail antirotation (PFNA) blades on implant purchase in osteoporotic bone. We investigated the effect of different localizations and amounts of bone cement. Polyurethane foam specimens were instrumented with a PFNA blade and subsequently augmented with PMMA bone cement. Eight study groups were formed based on localization and amount of cement volume related to the blade. All specimens underwent cyclic loading with physiological orientation of the force vector until construct failure. Foam groups were compared between each other and to a cadaveric control group. The experiments revealed a significant dependency of implant purchase on localization and amount of cement. Biomechanically favorable cement positions were found at the implant tip and at the cranial side. However, none of the tested augmentation patterns performed significantly inferior to the cadaveric benchmark. These findings will allow surgeons to further reduce the amount of injected PMMA, decreasing the risk of cement leakage or cartilage damage. With the use of fixation devices like helical blades for treating proximal femoral fractures, the incidence of cut-out of cephalic implants has decreased.1-5 Nevertheless failures occur. Besides surgeon-related factors such as quality of the reduction and implant positioning, bone quality plays an important role in the occurrence of mechanical complications. 6,7 Due to the aging population and relatively poor compliance to drugs that prevent osteoporotic fractures, the incidence of osteoporosis related fractures will increase.

show abstract

The new proximal femoral nail antirotation (PFNA®) in daily practice: Results of a multicentre clinical study

Cited by 300 publications

References 16 publications

Standardised cement augmentation of the PFNA using a perforated blade: A new technique and preliminary clinical results. A prospective multicentre trial

Standardised cement augmentation of the PFNA using a perforated blade: A new technique and preliminary clinical results. A prospective multicentre trial

Pelvic Migration of Lag Screw Following Fixation of an Intertrochanteric Femur Fracture with Proximal Femoral Nail

Cement augmentation of hip implants in osteoporotic bone: How much cement is needed and where should it go?

Contact Info

Product

Resources

About