Treatment of peritrochanteric fractures with the Endovis BA cephalomedullary nail: multicenter study of 1091 patients

Caiaffa, Vincenzo; Vita, Davide De; Laforgia, R.; Sessa, Giuseppe; Varsalona, R.; Girolami, Marco; Mignani, G; G, Turi; Micaglio, Andrea; Manca, Mario; Sancin, A.

doi:10.1007/s10195-007-0172-y

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…The preoperative choice of length depends on the distal extent of the fracture. A medium-length nail allows easier insertion than a long nail and distal locking in combination with a targeting jig [21]. …”

Section: Discussionmentioning

confidence: 99%

Failure of intertrochanteric nailing due to distal nail jamming

Maniscalco

Rivera

D'ascola

et al. 2012

J Orthopaed Traumatol

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Nail impingement against the anterior femoral cortex during nail insertion, or anterior cortex penetration, has been described in the literature as a worrying complication. We describe a previously unreported surgical failure due to a compromised dynamic distal locking caused by distal jamming of the nail. An 80-year-old male suffered a closed right intertrochanteric femoral fracture. Due to the presence of a long medial fragment, a 240 mm long titanium trochanteric nail was chosen to stabilize the fracture. Dynamic distal locking was performed by placing the distal screw at the inferior rim of the elliptical locking hole to allow compression of the fracture site during weight-bearing. Six-month X-ray follow-up revealed a broken nail and nonunion of the fracture due to failed dynamization of the distal locking screw. The nail was removed and replaced by a total arthroplasty. Due to the femoral anterior bow of the shaft, anterior cortical impingement of the distal tip of a nail may result in the failure of the nail to slide within the diaphyseal canal when using a medium-length nail preventing compression of the fracture. Dynamic distal locking can be ineffective if the ability of the distal nail to slide within the diaphyseal canal is hindered. This type of scenario can represent an opportunity for anterior nail impingement. Distal jamming of the nail can thus compromise dynamic compression at the fracture site during loading, thus inducing nonunion of the fracture, and leading to breakage of the osteosynthesis device. For these reasons, caution is recommended when using medium-length trochanteric nails for unstable trochanteric fractures.

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Section: Discussionmentioning

confidence: 99%

Failure of intertrochanteric nailing due to distal nail jamming

Maniscalco

Rivera

D'ascola

et al. 2012

J Orthopaed Traumatol

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“…Nevertheless, it must be stressed that, with Endovis BA the same key features that proved successful with Endovis were emphasized and improved with the state-of-the-art production technologies and materials. Overall, Endovis BA evolved toward higher patient tolerability while maintaining safety and improving effectiveness [5].…”

Section: Dear Editormentioning

confidence: 99%

“…• Dimensions -Endovis BA is about 15% smaller.Nevertheless, it must be stressed that, with Endovis BA the same key features that proved successful with Endovis were emphasized and improved with the state-of-the-art production technologies and materials. Overall, Endovis BA evolved toward higher patient tolerability while maintaining safety and improving effectiveness [5].The study we documented in the referred paper [1] was performed using Endovis BA nail (in the period 2007-2009). Hopefully, on the basis of the additional information provided here (which is not anyhow influencing the study's results), perspective readers will be able to adapt the issues faced in the discussion and conclusion sections to Endovis BA rather than to Endovis.…”

mentioning

confidence: 99%

The Treatment of Intertrochanteric Fractures of the Femur with Endovis Nail

Geraci¹,

Ricciardi²,

Mingozzi³

et al. 2013

Ortop Traumatol Rehabil

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Dear Editor,further to the stimulating discussion between the Authors and some readers, we feel that some details about the paper we authored [1] should be clarified.For instance, we called the analyzed system Endovis while the exact name is Endovis Bio Advanced (Endovis BA). Both devices are pertrochanteric intramedullary nails, both are manufactured by Citieffe s.r.l., but Endovis BA represents the evolution of Endovis nail (which has been no more on the market since 2008). The underlying concept design is the same for both nails; in fact, they are both equipped with two parallel cephalic screws and they both allow for distal locking. The two parallel cephalic screws are designed to control and reduce undesired side-effects such as rotational instability and femoral head "cut-off" [2]. Both are available in two different versions (Standard and Medium, Endovis BA is completed by a Long version), and have cervical-diaphyseal angulation to naturally fit the procurved femoral anatomy. Both have a distal diapason profile in order to decrease stiffness difference between the nail and the hosting bone and, consequently, avoid excessive contact stress generation.The main differences between the two systems are represented by [3], [4]: • Material -Endovis BA is made of titanium, whereas Endovis was made of stainless steel. • Cephalic screws -in Endovis BA they have the same diameter, whereas in Endovis they had two different diameters. • Dimensions -Endovis BA is about 15% smaller.Nevertheless, it must be stressed that, with Endovis BA the same key features that proved successful with Endovis were emphasized and improved with the state-of-the-art production technologies and materials. Overall, Endovis BA evolved toward higher patient tolerability while maintaining safety and improving effectiveness [5].The study we documented in the referred paper [1] was performed using Endovis BA nail (in the period 2007-2009). Hopefully, on the basis of the additional information provided here (which is not anyhow influencing the study's results), perspective readers will be able to adapt the issues faced in the discussion and conclusion sections to Endovis BA rather than to Endovis.

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“…The Endovis® proximal femoral nail (EN) has been designed by Citieffe® (Italy) to solve the problems associated with the use of intramedullary fixation devices. Some studies have demonstrated a good outcome with few complications after treatment with this intramedullary femoral nail [9,10]. EN is made of a titanium alloy with a cervicodiaphyseal angle of 130 degrees, a metaphyseal angle of 5 degrees and a total length of 195 mm (standard nail) or 220 mm (medium nail).…”

Section: Introductionmentioning

confidence: 99%

The treatment of intertrochanteric fractures of the femur with Endovis nail

Geraci

Martorana

2011

Ortopedia, traumatologia, rehabilitacja

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SUMMARYBackground. The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly persons with osteoporosis. The imperative goals of treatment are early mobilization by means of stable fixation using as minimally invasive a procedure as possible. Nowadays, there is an increasing interest in intramedullary nailing, especially for unstable intertrochanteric fractures. The aim of the present paper is to assess the efficacy of closed intramedullary osteosynthesis with the proximal femoral nail (Endovis®) in the treatment of peritrochanteric fractures to solve the problems associated with the use of intramedullary fixation devices.Material and methods. The authors describe their experience with 87 stable and unstable proximal extracapsular femoral fractures treated with the Endovis femoral nail from July 2007 to March 2009. The results were evaluated clinically, functionally and radiographically during the 1st, 3th, 6th and 12th months post-op. Pre-injury activity and functional levels were recorded using the modified Harris hip score and V.A.S. score.Results. Postoperative radiographs showed a near-anatomical fracture reduction in 85% of patients. Three were the cases of cut-out, one case of valgus and two cases of shortening of the operated leg (<1 cm). The Harris Hip Score increased between the thirtieth and ninetieth postoperative day, accompanied by a significant decrease in pain symptoms and functional limitation.Conclusions. 1. The application of an intramedullary nail provides primary stability of the fracture. 2. The Endovis nail constitutes a powerful synthesis for stable and unstable fractures of the trochanteric region, in which is difficult to reconstruct appropriate continuity between the medial and posterior cortical layers. 3.The good mechanical stability of the nail allows rapid mobilization and early functional recovery. 4. The presence of an additional anti-rotational screw and the free sliding mechanism of the lag screw may increase rotational stability of cervico-cephalic fragments and decrease overload on the femoral head.

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Treatment of peritrochanteric fractures with the Endovis BA cephalomedullary nail: multicenter study of 1091 patients

Cited by 7 publications

References 15 publications

Failure of intertrochanteric nailing due to distal nail jamming

Failure of intertrochanteric nailing due to distal nail jamming

The Treatment of Intertrochanteric Fractures of the Femur with Endovis Nail

The treatment of intertrochanteric fractures of the femur with Endovis nail

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