A Clinical and Biomechanical Study

Jacobs, Rae R.; McClain, Oza; Armstrong, H. James

doi:10.1097/00003086-198001000-00009

Cited by 43 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When the hip is loaded, unstable fractures tend to outward rotate and Varus angulate, resulting in limb shortening and abductor mechanism insufficiency [ 5 ]. In the surgical treatment of stable intertrochanteric fractures, sliding and compression dynamic hip screws are considered the “gold standard” [ 22 , 23 ]. In intertrochanteric fractures treated with sliding screw plates, Wolfgang et al observed mechanical complication rates of 9% for stable fractures and 19% for unstable fractures [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

Tang,

Wang,

Wang

et al. 2023

Eur J Med Res

View full text Add to dashboard Cite

Background There is no consensus about intertrochanteric fractures with lateral wall treated with intramedullary nail—proximal femoral nail antirotation (PFNA). The aim of the present study was to compare function outcomes between lateral wall and no lateral wall fractures after surgery by PFNA. Methods This retrospective study evaluated patients with or without lateral wall fractures who underwent PFNA between January 2015 and June 2018. The operative time, intraoperative blood loss, time to fracture healing, complications and functional outcomes qualified by Harris hip score and Parker − Palmer mobility score (PPMS) were compared between the two groups. Results Two groups were comparable with regard to patient age, sexual distribution, mechanism of injury, fracture type, body mass index (BMI), Time to surgery, American Society of Anesthesiologists (ASA) score and quality of reduction. The incomplete group had a longer operation time (54.1 ± 8.74 min vs. 51.0 ± 9.86 min) and more intraoperative blood loss (228.4 ± 48.8 ml vs. 151.3 ± 43.5 ml) in comparison with the control group (P < 0.01). Regarding functional outcome, the HHSs of the two groups were 76.2 ± 11.6 vs 75.6 ± 12.5 at the 3 months (P = 0.603), 81.9 ± 9.4 vs 82.6 ± 8.7 at the six months (P = 0.224), 83.8 ± 6.6 vs 84.5 ± 6.0 at the twelve months 85.2 ± 5.5 vs 86.0 ± 5.8 at the twenty-four months (P > 0.05), respectively. Similar results were obtained about PPMS. We found no difference in Weight bearing time, Time of fracture healing, and Complications between incomplete group and intact group. Conclusions There is no substantial difference in functional results or complication rates for intertrochanteric fractures with lateral wall fractures, except from increased blood loss and operation time. We believe that an intramedullary nail will be sufficient to repair an intertrochanteric fracture with or without a lateral wall fracture.

show abstract

Section: Discussionmentioning

confidence: 99%

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

Tang,

Wang,

Wang

et al. 2023

Eur J Med Res

View full text Add to dashboard Cite

show abstract

“…The loss of blood mainly occurred in the procedure of the medullary canal was extensively reamed because of the large diameter of the proximal aspect of the implant. Biomechanically, although intramedullary nail is the strongest option among osteosynthesis materials, [16,17] there were no significant differences between the intramedullary and extramedullary treatment groups with regard to the clinical outcome, [18] which was consistent with our study that there was no statistical difference between PFNA and EF groups in terms of postoperative final clinical function, as assessed with HHS and SF-36 Physical Health at the different time points, even though the HHS and SF-36 Physical Health scores were higher in the PFNA than EF group in the first semester. Some reasons may be attributed to this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Proximal femoral nail antirotation versus external fixation for unstable intertrochanteric fractures in elderly patients: A randomized controlled trial

Liang

Liu

et al. 2022

Medicine

View full text Add to dashboard Cite

Background: This study aimed to compare the clinical and radiographic outcomes of the proximal femoral nail antirotation (PFNA) and external fixation in the management of unstable intertrochanteric fractures in elderly patients.Methods: Eighty-seven of 114 patients with unstable intertrochanteric fractures were included in this study between January 2015 and June 2019, 46 were fixed with PFNA implant and 41 with external fixator. Patient baseline characteristics, functional and radiographic results, and postoperative complication were documented and compared between the 2 groups.Results: Prolonged operation duration, increased fluoroscopy time, and excess blood loss occurred in PFNA group. The functional results scores seemed higher in the PFNA than external fixation group in the first semester, and thereafter, there was no significant difference between groups. On early postoperative radiographs, better femur neck-shaft angle was acquired in the external fixators device, but the difference did not continue at final visit. The incidence rate of overall complications was 43.5% for the group PFNA and 100% for the group external fixation.Conclusions: Fewer postoperative complications occurred in PFNA than external fixator group when unstable intertrochanteric fractures were treated. Nevertheless, there was no significant difference detected in final functional and radiographic outcome between the 2 groups.

show abstract

“…During weight bearing of an unstable and mal reduced fracture, a load sharing mechanical loss result [13]. Unstable peritrochanteric fractures treated with Sliding Hip Screw (SHS) and dynamic intamedullary nail (IMN) may lead to deformity of the femoral head and cut out of the lag screw, observed as mechanical failure of osteosynthesis [14][15][16]. Over compression femoral neck shortening can lead to limb length discrepancy and is a wellknown clinical finding after fixation with SHS and IMN, particularly in geriatric patients [10,12,17].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Peritrochanteric Fractures Treatment with an Antegrade Trochanteric Static Lag Screw Nail (Inter TAN)

Karampinas

Vlamis

Papadelis

et al. 2016

BJMMR

View full text Add to dashboard Cite

Background:The preferred implant (intramedullary or extramedullary) of peritrochanteric fractures treatment is still on debate. The new cephalomedullary nail InterTAN permits intraoperative linear compression and prevents the excessive neck sliding, control shortening and varus collapse of the neck, minimizing the risk of malunion or nonunion of the fracture. The aim of this study is to determine the clinical and functional outcomes of unstable peritrochanteric fractures treatment with the use of the InterTAN. Methods and Results: 126 consecutive unstable peritrochanteric fractures treated with an antegrade trochanteric nail InterTAN introduced to the study. The patients studied clinically and radiologically with the Harris Hip Score, Visual Analog Scale score and standard two view x-rays. Have been calculated intraoperatively and postoperatively at every follow up meeting the Tip Apex Original Research ArticleIndex and the fracture Gap. The mean follow up was 19 months, mean age of the patient's was 80.3 years and mean hospitalization time was 7.8 days. The mean Tip Apex Distance (TAD) immediately post-operatively was 22.34 mm. The mean fracture gap immediately post-operatively was 3 mm. The TAD and the fracture gap remain invariable until the last follow up. The modified-HHS was 85.7/91 at the last follow up (67-91) and the VAS 0.6 (0-10). Conclusion:The results of the new intertrochanteric antegrade nail InterTAN were satisfactory in most elderly patients. As a result of the negligible complication rate and improved clinical outcomes this implant is now the standard treatment for all unstable intertrochanteric fractures at our department.

show abstract

A Clinical and Biomechanical Study

Cited by 43 publications

References 0 publications

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

Proximal femoral nail antirotation versus external fixation for unstable intertrochanteric fractures in elderly patients: A randomized controlled trial

Clinical Outcome of Peritrochanteric Fractures Treatment with an Antegrade Trochanteric Static Lag Screw Nail (Inter TAN)

Contact Info

Product

Resources

About