Comparison of the biomechanical effects of pertrochanteric fixator and dynamic hip screw on an intertrochanteric femoral fracture using the finite element method

İnal, Sermet; Taşpınar, Ferruh; Gülbandılar, Eyyup; Gök, Kadir

doi:10.1002/rcs.1584

Cited by 27 publications

(17 citation statements)

References 33 publications

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“…Moreover, in China, 70% of surgeons prefer PFNA over DHS for treating a stable intertrochanteric fracture in active elderly patients [10]. Other studies have previously reported that DHS was the best choice for the initial treatment of stable intertrochanteric fractures [6, 7, 9, 16, 17]. Although the complication rates of DHS devices ranged from 12 to 34% [10], DHS was still regarded as a preferred device for stable intertrochanteric fractures in active elderly patients.…”

Section: Discussionmentioning

confidence: 99%

“…There is currently no consensus about which type of implant to use or what technique to perform in patients with stable intertrochanteric fractures previously treated with DHS fixation or PFNA. Some studies reported no difference in the clinical and radiological outcomes [7–12, 19, 20], while others reported higher complication rates and revision rates for one approach after CTHA [17, 21]. To address this controversy, we compared the clinical and radiological outcomes of CTHA after a failed PFNA or DHS fixation for stable intertrochanteric fractures.…”

Section: Discussionmentioning

confidence: 99%

“…A growing but still very limited body of literature has shown that conversion from prior PFNA fixation is better compared with conversion from prior DHS fixation with regard to the postoperative HHS after 0.5–1.5 years of follow-up [8, 15, 17, 25]. However, similar to a multi-centre, randomized study [26], we found no obvious differences in the postoperative HHS between the groups treated with the two types of conversions after a median of 3 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

Zeng

Zhan

Zhang

et al. 2017

BMC Musculoskelet Disord

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BackgroundConversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years.MethodsBetween January 2005 and April 2014, we retrospectively reviewed 142 active elderly patients treated at our institution (a single institution study). A total of 72 patients (72 hips; 41 women, 31 men; mean age 76.9 years old; range 60–92 years old) who underwent conversion of a failed PFNA to a THA were compared with 70 patients (70 hips; 36 women, 34 men; mean age 75.0 years old; range 60–90 years old) who underwent CTHA after a failed DHS fixation. The mean follow-up periods were 48 (range 43–52) and 48 (range 44–52) months for the DHS and PFNA groups, respectively. Clinical and radiologic evaluations were performed on all patients. The primary outcome was the Harris Hip Score (HHS). The secondary outcomes were the complication rates.ResultsThe Harris Hip Score (HHS) improved from 50.61 ± 3.23 preoperatively to 85.28 ± 4.45 at the last follow-up in the PFNA group and from 51.46 ± 3.90 to 84.50 ± 4.34 in the DHS group, with no significant differences noted between the groups at each follow-up (P > 0.05). However, the complication rate in the converted DHS patients was significantly higher (42.9%) than that in the converted PFNA patients (20.8%; P = 0.003). Thirty-seven PFFs (2.4%) occurred during a mean follow-up of 44.4 months. The incidence of periprosthetic fractures was found to be significantly higher (P = 0.021) for the DHS group (15.7%) than for the PFNA group (4.2%).ConclusionsCTHA after failed DHS fixations of stable intertrochanteric fractures might be associated with a significantly higher complication rate than CTHA after failed PFNA fixations. Therefore, PFNA patients with stable intertrochanteric fractures may be more suitable for CTHA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

Zeng

Zhan

Zhang

et al. 2017

BMC Musculoskelet Disord

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“…It is a major treatment for intertrochanteric fractures. [12][13][14][15] The proximal end and binding position of the plate have strong bending resistance so create strong fixation, better sliding function. It also has static and dynamic characteristics of pressurizing action and applies pressure on fracture ends.…”

Section: Discussionmentioning

confidence: 99%

Inter-Trochanteric Fractures;

Alam¹,

Jabeen

2019

TPMJ

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ABSTRACT… Introduction: Hip fractures are a leading cause of death and disability among elderly. Approximately half of these injuries are intertrochanteric fractures and the incidence is continuously increasing. These fractures are the most common injuries around the hip region and are more common in elderly people. Different types of implants were tried at different times for internal fixation of these fractures, of which dynamic hip screw has remained the most popular one. But with the advent of some newer implants, the efficacy of dynamic hip screw is being questioned. Objectives: To determine the results of dynamic hip screw as a method of internal fixation in closed stable as well as unstable intertrochanteric fractures of femur in adults. Design: Descriptive case series. Setting: The study was conducted in orthopedic department Allied Hospital Faisalabad. Period: 11months (from 26 th , march, 2015 to 25 th Feb, 2016). Subjects and Methods: Sixty cases of intertrochanteric fractures were included and operated for internal fixation with dynamic hip screw under fluoroscopic guidance. Pre, per and post-operative findings during hospital stay and follow-up period were recorded. Results: We had a total 60 cases, 20 patients in group A stable intertrochanteric fractures and 40 patients in group B unstable intertrochanteric fractures. We have reported the follow up study up to 20 weeks. There were 10 (50%) male and 10 (50%) female in group A. In group B 27 (67.5%) males and 13 (32.5%) females. The youngest pt was 25 years in group A and 16 years in group B. The mean age in group A was 59.10 and st/deviation 16.942. In group B mean age was 54.85 and st/ deviation 14.123. Infection rate in group A was 5%. In group B superficial infection was 5% and deep infection was 2.5%. Nonunion in both groups was 5%. The failure rate was 5% in group A and 20% in group B. Conclusion: The use of Dynamic hip screw with aside plate is associated with good results and acceptable complication rate. Dynamic hip screw is implant of choice in both stable and unstable intertrochanteric fractures.

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“…It is also used as a reliable technique for validation of experimental or analytical results. In addition, several scientists similarly examined the optimal configuration, implant materials, fatigue behavior of implant materials, metal turning, bone drilling and bone screwing process using the computer aided FEA tool [18][19][20][21][22][23][24].…”

Section: Computer Aided Finite Elementmentioning

confidence: 99%

Biomechanical Effects of Four Different Configurations In Salter Harris Type 4 Distal Femoral Epiphyseal Fractures

2020

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Comparison of the biomechanical effects of pertrochanteric fixator and dynamic hip screw on an intertrochanteric femoral fracture using the finite element method

Abstract: This study demonstrated that PTF is more favorable than DHS for early axial loading and ambulation.

Cited by 27 publications

References 33 publications

Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

Conversion to total hip arthroplasty after failed proximal femoral nail antirotations or dynamic hip screw fixations for stable intertrochanteric femur fractures: a retrospective study with a minimum follow-up of 3 years

Inter-Trochanteric Fractures;

Biomechanical Effects of Four Different Configurations In Salter Harris Type 4 Distal Femoral Epiphyseal Fractures

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