A comparison between proximal femoral nail antirotation (PFNA) and inter Tan nail for the surgical treatment of unstable intertrochanteric fracture: A case series

Chen, Guobin; Cui, Yu; Maoquan, Zhao; Qishu, Xiao

doi:10.1016/j.asjsur.2021.05.025

Cited by 5 publications

(5 citation statements)

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“…Surgical treatment mainly includes internal fixation (intramedullary fixation, extramedullary fixation), external fixation brace, artificial hip replacement, Sheehan et al (12). Common intramedullary fixation includes PFN, PFNA, Gamma, and InterTAN, and extramedullary fixation includes DHS, DCS, and PCCP (12)(13)(14)(15). In recent years, many experts have conducted clinical studies on intramedullary and extramedullary fixation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of curative effect between OBS assisted by 3D printing and PFNA in the treatment of AO/OTA type 31-A3 femoral intertrochanteric fractures in elderly patients

Huang,

Xiong,

Mithu

et al. 2023

Front. Med.

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ObjectiveTo compare and analyze the Ortho-Bridge System (OBS) clinical efficacy assisted by 3D printing and proximal femoral nail anti-rotation (PFNA) of AO/OTA type 31-A3 femoral intertrochanteric fractures in elderly patients.MethodsA retrospective analysis of 25 elderly patients diagnosed with AO/OTA type 31-A3 femoral intertrochanteric fracture was conducted from January 2020 to August 2022 at Yan’an Hospital, affiliated to Kunming Medical University. The patients were divided into 10 patients in the OBS group and 15 in the PFNA group according to different surgical methods. The OBS group reconstructed the bone models and designed the guide plate by computer before the operation, imported the data of the guide plate and bone models into a stereolithography apparatus (SLA) 3D printer, and printed them using photosensitive resin, thus obtaining the physical object, then simulating the operation and finally applying the guide plate to assist OBS to complete the operation; the PFNA group was treated by proximal femoral nail anti-rotation. The operation time, the intraoperative blood loss, Harris hip score (HHS), Oxford Hip Score (OHS), and complications were compared between the two groups.ResultsThe operation time and the intraoperative blood loss in the PFNA group were less than that in the OBS group, and there was a significant difference between the two groups (P < 0.05). The HHS during the 6th month using OBS was statistically higher than PFNA (P < 0.05), however, there were no significant differences in OHS during the 6th month between the OBS group and PFNA group (P > 0.05). The HHS and OHS during the 12th month in the OBS group were statistically better than in the PFNA group (P < 0.05).ConclusionThe OBS assisted by 3D printing and PFNA are effective measures for treating intertrochanteric fractures. Prior to making any decisions regarding internal fixation, it is crucial to evaluate the distinct circumstances of each patient thoroughly.

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Section: Discussionmentioning

confidence: 99%

Comparison of curative effect between OBS assisted by 3D printing and PFNA in the treatment of AO/OTA type 31-A3 femoral intertrochanteric fractures in elderly patients

Huang,

Xiong,

Mithu

et al. 2023

Front. Med.

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“…(71 min). 24 , 25 The key point is that when the reduction during fixation surgery is suboptimal, an insertion site on the medial femoral trochanter can be selected, and pre‐drilling can be performed first at this location. The finger reduction tool is then inserted into the femoral medullary cavity.…”

Section: Discussionmentioning

confidence: 99%

“…(61 min) and Kim et al . (71 min) 24,25 . The key point is that when the reduction during fixation surgery is suboptimal, an insertion site on the medial femoral trochanter can be selected, and pre‐drilling can be performed first at this location.…”

Section: Discussionmentioning

confidence: 99%

“…The operation time ranged from 31 to 101 min with a mean of 65.67 AE 14.17 min, which was comparable to the time reported by Chen et al (61 min) and Kim et al (71 min). 24,25 The key point is that when the reduction during fixation surgery is suboptimal, an insertion site on the medial femoral trochanter can be selected, and pre-drilling can be performed first at this location. The finger reduction tool is then inserted into the femoral medullary cavity.…”

Section: Advantages Of This Technique and Precautions For Applicationmentioning

confidence: 99%

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Reduction with Pre‐Drilling Combined with a Finger Reduction Tool in Difficult‐to‐Reduce Intertrochanteric Fracture

Chen

et al. 2022

Orthopaedic Surgery

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Objective: To investigate the feasibility of pre-drilling combined with a finger reduction tool for the reduction of difficult-to-reduce intertrochanteric fractures.Methods: Patients diagnosed with complicated intertrochanteric fractures during the period from July 2016 to May 2021 at the Affiliated Hospital of our College were enrolled in this study. All patients underwent reduction by predrilling combined with a finger reduction tool followed by fixing with proximal femoral nail antirotation. The outcome of reduction was evaluated by intraoperative fluoroscopy. The operation time, intraoperative fluoroscopy frequency, and incidence of postoperative complications (including infection in the incision area, coxa vara, nail withdrawal, nail breakage, blade cut-out, lower limb vein thrombosis, and pulmonary embolism) were recorded to evaluate the speed of the operation, the difficulty of the operation, and the prognosis of the patient, respectively. The Harris hip score at 9 months after surgery was used to evaluate the hip recovery.Results: A total of 52 patients (17 men and 35 women), 61-88 (77.54 AE 7.40) years of age were included in the study. There were 14 patients with cardiovascular or cerebrovascular disease, ten patients with diabetes, three patients with Parkinson's disease, and three patients with respiratory diseases. The fractures included in the study were classified according to the Orthopedic Trauma Association 31 classification system as type A2.2 (n = 36) or type A2.3 (n = 16). The time from injury to surgery was 1-11 (3.35 AE 1.78) days, and the operation time ranged 31-101 (65.67 AE 14.17) min. The intraoperative blood loss ranged from 40 to 100 (67.69 AE 18.24) mL, and the number of intraoperative fluoroscopy images obtained was 12 to 32 (20.42 AE 5.27). The Harris hip score at 9 months after surgery ranged from 84 to 94 (90.06 AE 2.15). Patients were followed for 9-16 (10.63 AE 1.61) months. One patient died of acute myocardial infarction at 9 months after surgery. One patient suffered from nail withdrawal 5 months postoperation and thus underwent hemiarthroplasty.Conclusions: Satisfactory reduction can be achieved using a pre-drilling femoral trochanter combined with a finger reduction tool for the management of difficult-to-reduce complex intertrochanteric fractures. This technique does not increase surgical trauma and also reduces the dose of radiation administered to the patient.

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“…However, they differ in structural design, and individual advantages/disadvantages when used in the treatment of intertrochanteric fractures. 5 Recent clinical research data is available on the use of InterTan and PFNA-II in patients with intertrochanteric fractures, however the choice of device is still controversial. [6][7][8] The purpose of this study was to compare the impact and safety of InterTan and PFNA-II in the treatment of intertrochanteric fractures on patients' functional rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

A comparison of functional and radiological outcome of combine compression antegrade intertrochanteric nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in elderly patients with intertrochanteric fractures

Zhu¹,

Zhao²,

Wang³

et al. 2022

Pak J Med Sci

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Objective: To compare the functional and radiological outcome of combine compression interlocking intramedullary nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in the treatment of elderly patients with intertrochanteric fractures. Methods: As a retrospective cohort study, records of 88 patients with intertrochanteric fractures treated in our hospital from January 1st, 2019 to July 31st, 2021 were retrospectively reviewed. According to treatment records, it included 45 patients treated with InterTan (Group-A) and 43 patients treated with PFNA-II (Group-B). The operation safety and functional rehabilitation of the two groups were compared and analyzed. Results: This study included 88 patients with intertrochanteric fractures (mean [SD] age, 68.72 [0.10] years at baseline), of whom 52 (59.09%) were males and 36 (40.91%) were females. Operation time and intraoperative blood loss in Group-B were less than Group-A, while fracture healing time was shorter in Group-A. The fracture separation distance was measured four weeks after the operation. The widening rate of the fracture line in Group-A was lower than Group-B (4.4% vs.18.6%; P<0.05). The incidence of complications in Group-A was lower than Group-B (4.4% vs.18.6%; P<0.05). At three, six and twelve months after the operation, the Harris hip score of the two groups was higher than at discharge (P<0.05), with no significant difference between groups (P>0.05). Conclusions: We found no significant difference in the functional outcome in elderly patients with intertrochanteric fractures treated with InterTan and PFNA-II. Early fracture healing and reduced complication rate however has been noted with InterTan. doi: https://doi.org/10.12669/pjms.39.1.6946 How to cite this: Zhu Z, Zhao Z, Wang X, Wang Z, Guan J. A comparison of functional and radiological outcome of combine compression antegrade intertrochanteric nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in elderly patients with intertrochanteric fractures. Pak J Med Sci. 2023;39(1):96-100. doi: https://doi.org/10.12669/pjms.39.1.6946 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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A comparison between proximal femoral nail antirotation (PFNA) and inter Tan nail for the surgical treatment of unstable intertrochanteric fracture: A case series

Cited by 5 publications

References 2 publications

Comparison of curative effect between OBS assisted by 3D printing and PFNA in the treatment of AO/OTA type 31-A3 femoral intertrochanteric fractures in elderly patients

Comparison of curative effect between OBS assisted by 3D printing and PFNA in the treatment of AO/OTA type 31-A3 femoral intertrochanteric fractures in elderly patients

Reduction with Pre‐Drilling Combined with a Finger Reduction Tool in Difficult‐to‐Reduce Intertrochanteric Fracture

A comparison of functional and radiological outcome of combine compression antegrade intertrochanteric nail (InterTan) and proximal femoral nail anti-rotation II (PFNA-II) in elderly patients with intertrochanteric fractures

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