Treatment of Middle‐up Part Long‐segment Femoral Fracture with Long Proximal Femoral Nail Antirotation

Yang, Lin; Li, Renbin; Xiong, Ge; Zhuang, Yan; Xiong, Shengren; Huang, Xian-gui; Zhang, Yi-yuang

doi:10.1111/os.12166

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Previous studies have highlighted several key points regarding surgical procedures for better surgical outcomes of ipsilateral hip and shaft fractures118). However, most of the surgical recommendations in those studies have been limited to general guidelines of closed intramedullary nailing that minimize soft tissue damage around the fracture site and maintain good alignment.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Surgical Outcomes of Intertrochanteric or Subtrochanteric Fractures Associated with Ipsilateral Femoral Shaft Fractures Treated with Closed Intramedullary Nailing: A Review of 31 Consecutive Cases over Four Years at a Single Institution

et al. 2019

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Purpose: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. Materials and Methods: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. Results: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11-25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. Conclusion: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures

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Section: Discussionmentioning

confidence: 99%

Characteristics and Surgical Outcomes of Intertrochanteric or Subtrochanteric Fractures Associated with Ipsilateral Femoral Shaft Fractures Treated with Closed Intramedullary Nailing: A Review of 31 Consecutive Cases over Four Years at a Single Institution

et al. 2019

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“… 9 , 10 Nonetheless, the PFNA method can induce additional surgical trauma to the proximal femur during reaming of the medullary cavity and by damaging the lateral cortex. 5 , 11 In addition, this technique does not provide strong stabilization in patients with severe osteoporosis or complicated fractures involving intertrochanteric coronal splitting or reverse obliquity fractures, which can induce postoperative complications such as varus deformity and fixation failure. 12 …”

Section: Introductionmentioning

confidence: 99%

Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures

Xuan

Wang

Ma³

et al. 2016

Medicine

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The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures.A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system–distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] −1.48, 95% confidence interval [CI] −2.92 to −0.05; OR −7.08, 95% CI −8.32 to −5.84; OR −2.71, 95% CI −4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications.Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative.

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Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures: a retrospective comparative study based on propensity score matching

Shin

Jang

Jung

et al. 2020

Eur J Trauma Emerg Surg

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Treatment of Middle‐up Part Long‐segment Femoral Fracture with Long Proximal Femoral Nail Antirotation

Abstract: Closed reduction or limited open reduction with PFNA-long is an effective treatment for long-segment femoral fracture in middle-up part, with good strength in fixation, high rate of fracture union, early functional recovery and low rate of complications.

Cited by 5 publications

References 13 publications

Characteristics and Surgical Outcomes of Intertrochanteric or Subtrochanteric Fractures Associated with Ipsilateral Femoral Shaft Fractures Treated with Closed Intramedullary Nailing: A Review of 31 Consecutive Cases over Four Years at a Single Institution

Characteristics and Surgical Outcomes of Intertrochanteric or Subtrochanteric Fractures Associated with Ipsilateral Femoral Shaft Fractures Treated with Closed Intramedullary Nailing: A Review of 31 Consecutive Cases over Four Years at a Single Institution

Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures

Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures: a retrospective comparative study based on propensity score matching

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