TREATMENT OF REVERSE OBLIQUE AND TRANSVERSE INTERTROCHANTERIC FRACTURES WITH USE OF AN INTRAMEDULLARY NAIL OR a 95° SCREW-PLATE

Sadowski, Christophe Raphael; Lübbeke, Anne; Saudan, Marc; Riand, N.; Stern, Richard; Hoffmeyer, Pierre

doi:10.2106/00004623-200203000-00007

Cited by 340 publications

(208 citation statements)

References 14 publications

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“…23,24 One study specifically looked at transverse and reverse oblique (often classified as subtrochanteric, analogous to a Seinsheimer IIC fracture) intertrochanteric fractures as per the classification of the Orthopaedic Trauma Association, but excluded fractures extending ≥5 cm from the distal lesser trochanter. 25 An implant failure rate of 32% in the fixed-angle plating (Dynamic Condylar Screw) group versus zero in the intramedullary nailing group (Proximal Femoral Nail) was reported. 25 Despite anatomic reduction, the mode of failure in the BP group was from plate or screw breakage (Fig.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Nailing versus Fixed Angle Blade Plating for Subtrochanteric Femoral Fractures: A Prospective Randomised Controlled Trial

Rahme

Harris

2007

J Orthop Surg (Hong Kong)

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Purpose. To compare closed intramedullary nailingto open reduction and internal fixation using a fixed angle blade plate for the management of subtrochanteric femoral fractures. Methods. 58 patients were equally randomised to undergo either an intramedullary nailing (IN) or fixed angle blade plating (BP). Results. There were no significant differences between the 2 groups with regard to age, time to surgery, operating time, receipt of blood transfusions, duration of hospital stay, or fracture classification. The revision rate was 28% (8/29) in the BP group and none in the IN group; the difference was statistically significant. Conclusion. Internal fixation using a fixed angle blade plate for subtrochanteric femoral fractures has higher implant failure and revision rates, compared to closed intramedullary nailing.

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Section: Discussionmentioning

confidence: 99%

Intramedullary Nailing versus Fixed Angle Blade Plating for Subtrochanteric Femoral Fractures: A Prospective Randomised Controlled Trial

Rahme

Harris

2007

J Orthop Surg (Hong Kong)

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“…Autores são de opinião que a haste PFN ® possibilita a obtenção de excelentes resultados no tratamento da fratura trocantérica instável do fêmur, principalmente quanto à estabilidade propiciada pelo implante, que permite deambulação precoce com melhor reabilitação funcional do paciente idoso e alto índice de consolidação decorrente da preservação do envelope de partes moles em torno da fratura (37)(38)(39)(40) .…”

Section: Discussionunclassified

Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Guimarães¹,

Guimarães²,

Franco³

2008

Rev. bras. ortop.

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“…In a prospective randomized study of 210 patients with intertrochanteric fractures treated with either a SHS or a long Gamma 1 nail, Barton et al [3] found no differences between groups in reoperation rates, mortality rates, or EuroQol 5D scores. Although many surgeons prefer a SHS for fixing stable fractures [4,24,26], the intramedullary nail (IMN) reportedly has greater mechanical resistance to failure, a loadbearing device, and thus increased mechanical stability in unstable fractures, especially the reverse oblique types [15,20,22]. The proximal thick part of the nail leans against the proximal fragment preventing medialization of the shaft.…”

Section: Introductionmentioning

confidence: 99%

Which Implant Is Better for Treating Reverse Obliquity Fractures of the Proximal Femur: A Standard or Long Nail?

Okçu

Özkayın

Okta

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Reverse obliquity fractures of the proximal femur have biomechanical characteristics distinct from other intertrochanteric fractures and high implant failure rate when treated with sliding hip screws. Intramedullary hip nailing for these fractures reportedly has less potential for cut-out of the lag screw because of their loadbearing capacity when compared with extramedullary implants. However, it is unclear whether nail length influences healing.Questions/purposes We compared standard and long types of intramedullary hip nails in terms of (1) reoperation (fixation failure), (2) 1-year mortality rate, (3) function and mobility, and (4) union rate. Methods We conducted a pilot prospective randomized controlled trial comparing standard versus long (C 34 cm) intramedullary hip nails for reverse obliquity fractures of the proximal femur from January 2009 to December 2009. There were 15 patients with standard nails and 18 with long nails. Mean age was 79 years (range, 67-95 years). We determined 1-year mortality rates, reoperation rates, Parker-Palmer mobility and Harris hip scores, and radiographic findings (fracture union, blade cut-out, tip-apex distance, implant failure). Minimum followup was 12 months (mean, 14 months; range, 12-20 months). Results We found no difference in reoperation rates between groups. Two patients (both from the long-nail group) underwent revision surgery because of implant failure in one and deep infection in the other. There was no difference between the standard-and long-nail groups in mortality rate (17% versus 18%), Parker-Palmer mobility score (five versus six), Harris hip score (74 versus 79), union rate (100% in both groups), blade cut-out (zero versus one), and tip-apex distance (22 versus 24 mm). Conclusions Our preliminary data suggest reverse obliquity fractures of the trochanteric region of the femur can be treated with either standard or long intramedullary nails.

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TREATMENT OF REVERSE OBLIQUE AND TRANSVERSE INTERTROCHANTERIC FRACTURES WITH USE OF AN INTRAMEDULLARY NAIL OR a 95° SCREW-PLATE

Cited by 340 publications

References 14 publications

Intramedullary Nailing versus Fixed Angle Blade Plating for Subtrochanteric Femoral Fractures: A Prospective Randomised Controlled Trial

Intramedullary Nailing versus Fixed Angle Blade Plating for Subtrochanteric Femoral Fractures: A Prospective Randomised Controlled Trial

Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur

Which Implant Is Better for Treating Reverse Obliquity Fractures of the Proximal Femur: A Standard or Long Nail?

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