A rare complication of pelvic perforation by an excessive medial slide of the helical blade after treatment of an intertrochanteric fracture with proximal femoral nail anti-rotation: A case report and literature review

Chen, Xiaokun; Xiong, Jie; Liu, Yijun; Han, Qi; Wang, Tianbing; Zhang, Dianying

doi:10.1016/j.cjtee.2021.08.007

Cited by 3 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Helical blades have been associated with complications such as "cut-out" and "cut-through" rates. The most advantageous selection between the two screws remains ambiguous, necessitating more exploration [ 14 , 15 ]. Therefore, the study aims to compare the efficacy of the twin screw derotation type cephalomedullary nail with that of the single helical blade type cephalomedullary nail in the management of unstable intertrochanteric fractures.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Twin Screw Derotation Type Versus Single Helical Blade Type Cephalomedullary Nail in the Management of Unstable Intertrochanteric Fractures

Thusoo,

Nagpal,

Kudyar

et al. 2024

Cureus

View full text Add to dashboard Cite

Background: The intertrochanteric fracture is a frequently occurring fracture, often attributed to osteoporosis in older populations. Recently, there has been a proposal to perform early surgical fixation on elderly patients to facilitate early rehabilitation. This approach has been shown to have a beneficial effect in lowering comorbidities. The study aims to compare the efficacy of the twin screw derotation type cephalomedullary nail with that of the single helical blade type cephalomedullary nail in the management of unstable intertrochanteric fractures.Methodology: The research sample included patients from the orthopedic outpatient and emergency departments of Adesh Medical College and Hospital, Ambala Cantt, India, who were scheduled for surgery for unstable intertrochanteric femur fractures. The patients were categorized into two groups according to the kind of implant they were given: either a twin screw derotation cephalomedullary nail or a single helical blade cephalomedullary nail. The functional result was evaluated by comparing the modified Harris hip score (HHS). Patients with unstable intertrochanteric fractures, including reverse oblique fractures and fractures with posteromedial comminution, as well as patients who provided consent, were included in this study.Results: Thirteen individuals received treatment with proximal femoral nail antirotation (PFNA2), whereas 19 individuals received treatment with proximal femoral nail (PFN). The mean age in the PFNA2 group was 69.51, whereas the mean age in the PFN group was 70.804. There were three patients in the PFNA2 group and five patients in the PFN group who had a tip apex distance of more than 25 mm. According to the Cleveland index, nine patients in the PFNA2 group and eight patients in the PFN group had an implant location that was not optimum. Four patients in the PFNA2 group and seven patients in the PFN group had a neck shaft angle difference of more than 10° between their undamaged and operated sides. The mean HHS was 74.55 for the PFNA2 group and 69.88 for the PFN group. The PFNA2 group exhibited four problems, whereas the PFN group had five issues. Conclusion:The study found that both implants offer similar functional outcomes, with adherence to specific radiological parameters optimizing results. While both face similar challenges with osteoporosis, there was no notable distinction between them. Notably, the PFNA2 group showed superior outcomes in perioperative morbidity.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of Twin Screw Derotation Type Versus Single Helical Blade Type Cephalomedullary Nail in the Management of Unstable Intertrochanteric Fractures

Thusoo,

Nagpal,

Kudyar

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…Superomedial migration of the helical blade has a higher "cut through" rate which migrate into the femoral head and hip joint than the conventional one. [ 11 , 12 ] However, Schwarzkopf et al[ 13 ] found that both screws designed provided similar fixation strength for stabilization of four-part intertrochanteric fractures. A recent meta-analysis suggested that cephalomedullary implant type was not a risk factor for implant cut-out, then a tip-apex distance (TAD) of >25 mm was a reliable indicator for cut-out risk.…”

Section: Introductionmentioning

confidence: 99%

Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Huang

Wei

2022

Jt Dis Relat Surg

View full text Add to dashboard Cite

Currently, there are two surgical ways to treat intertrochanteric fractures among the elderly, including extramedullary or intramedullary fixation. [1,2] Although extramedullary fixation is the conventional treatment of intertrochanteric fractures, intramedullary fixation has become a more popular method with the development and progress of intramedullary instruments. [3] The optimal choice between the helical blade and lag screw is still controversial. [4][5][6] Some pieces of literature have reported that there is no difference in the clinical efficacy, excepted for the operation time that the lag screw is longer than that of the helical blade. [7] However, biomechanical studies have shown that the helical blade is superior to the conventional solid lag Objectives: In this review, we aimed to compare the radiological and functional outcomes between the helical blade and lag screw in treating intertrochanteric fractures among the elderly and to provide suggestions for clinical treatment. Materials and methods:Between January 1 st , 1990 and January 12 th , 2022, the literature search in document databases identified eligible randomized-controlled trials (RCT) studies directly comparing the helical blade and lag screws for treating hip fractures. The mechanical failure rates, the excellent and good rate of fracture reduction, Harris Hip Score (HHS), and postoperative hip pain of two intramedullary devices (helical blades versus lag screws) in patients with intertrochanteric fractures were analyzed using the RevMan software and Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The random-effects models were used for statistical analysis.Results: A total of 11 articles containing 1,146 patients for helical blade and lag screw comparison were included. Compared to the lag screws, the mechanical failure rate (odds ratio [OR]=0.71, 95% confidence interval [CI] 0.40-1.27, p=0.25), the excellent and good rate of fracture reduction (OR=1.33, 95% CI 0.61-2.90, p=0.48), HHS (mean differences 1.83, 95% CI -0.29-1.83, p=0.09), and postoperative hip pain (OR=0.41, 95% CI 0.14-1.21, p=0.11) were similar with the helical blades. There was no significant difference between the two implants in terms of the treatment outcomes. Conclusion:Both helical blades and lag screws are good choices for treating intertrochanteric fracture among elderly.

show abstract

Quantitative assessments of cerebral vascular damage with a silicon rubber casting method in photochemically-induced thrombotic stroke rat models

et al. 2007

View full text Add to dashboard Cite

A rare complication of pelvic perforation by an excessive medial slide of the helical blade after treatment of an intertrochanteric fracture with proximal femoral nail anti-rotation: A case report and literature review

Cited by 3 publications

References 24 publications

Comparison of Twin Screw Derotation Type Versus Single Helical Blade Type Cephalomedullary Nail in the Management of Unstable Intertrochanteric Fractures

Comparison of Twin Screw Derotation Type Versus Single Helical Blade Type Cephalomedullary Nail in the Management of Unstable Intertrochanteric Fractures

Comparison of helical blade versus lag screw in intertrochanteric fractures of the elderly treated with proximal femoral nail: A meta-analysis of randomized-controlled trials

Quantitative assessments of cerebral vascular damage with a silicon rubber casting method in photochemically-induced thrombotic stroke rat models

Contact Info

Product

Resources

About