Treatment for Trochanteric Fracture of the Femur with Short Femoral Nail: A Comparison between the Asian Intramedullary Hip Screw (IMHS) and the Conventional IMHS

Kawaji, Hidemi; Uematsu, Taro; Oba, Ryosuke; Satake, Yoshihiko; Hoshikawa, Naoya; Takai, Shinro

doi:10.1272/jnms.83.113

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The classification proposed by Russell-Taylor [18] mainly focuses on the piriformis fossa and the greater tubercle, which has important guiding significance for first-generation intramedullary nail treatment with the piriformis fossa as the entry point. However, with the evolution of internal fixation equipment, the opening of the new generation of intramedullary nails was gradually simplified to the opening at the top of the greater tubercle, and its practical significance gradually decreased.…”

Section: Discussionmentioning

confidence: 99%

Case series and finite element analysis of PFNA combined with cerclage wire for treatment of subtrochanteric fracture of femur

Huang

Zhang

2021

J Orthop Surg Res

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Objective To retrospectively analyze the clinical efficacy of PFNA combined with a cerclage wire in the treatment of 52 patients with unstable subtrochanteric fracture of the femur and to analyze the biomechanical effect of ligature on a fracture model. Methods In this study, 52 patients with unstable subtrochanteric fractures were treated in our orthopedic trauma center from June 2013 to July 2018. The Seinsheimer type IV fracture model was established using the patient’s CT data, and the joint surface of the distal femoral condyle and the external condyle were restrained. The femoral head was used as the loading point, and a force of 500 N was applied vertically along the long axis of the femoral shaft. Results All 52 patients were followed up for 12 to 37 months, with an average of 18.07 ± 4.38 months. According to the Sanders hip function score, 28 cases were excellent (55–60 points), 22 cases were good (45–54 points), and 2 cases were poor (35–44 points), with an excellent and good rate of 96.15%. Postoperative deep vein thrombosis occurred in 3 cases, and fracture nonunion occurred in 1 case. No infection, loose fracture of internal fixation or hip varus deformity occurred. The finite element analysis indicated that the displacement of the whole model decreased slightly and the relative sliding of the fracture block decreased, but the maximum stress of the femur increased after the addition of the cerclage wire. Conclusion The treatment of unstable subtrochanteric fracture of the femur with PFNA combined with cerclage wire has the advantages of simple operation, satisfactory reduction of fracture, stable fixation, and good recovery of limb function. The finite element analysis suggested that the biomechanical strength fixation was enhanced after the addition of cerclage wire. However, the local stress concentration of the tie may increase the risk of failure.

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Section: Discussionmentioning

confidence: 99%