Comparison of Third Generation Proximal Femoral Nails in Treatment of Reverse Oblique Intertrochanteric Fractures

Abstract

The purpose of the study is to evaluate the treatment results of reverse oblique AO/OTA 31A1 fractures that have highly mechanical instability risk with two third generation intramedullary nails. Methods: Twenty-eight patients (8 men, 20 women) treated by third generation proximal femoral nails [proximal femoral anti-rotation (PFNA)® or Intertan®] followed minimum one year were included. Average age was 65.0 (31-93) years. Clinical and radiological results, screw migration at one year and complications were recorded. Results: Mean operation time was 72.2 and 72.5 minutes, flouroscopy time was 64.4 and 64.7 seconds, mobilisation time was 2.1 and 2.2 days, full weight bearing time was 8.6 and 8.5 weeks, tip-apex distance was 20.1 and 20.2 mm, fracture healing time was 10.5 and 10.2 weeks, Harris hip score at one year was 80.5 and 83.5, neck-shaft angle difference at one year was 1.6 and 1.1 mm, screw migration at one year was found in 10 and 3 patients and mean migration distance was 3.1 and 0.4 mm for PFNA and Intertan nails respectively. No complications recorded that needs secondary intervention. Fracture healing obtained in all patients. Conclusion: Reverse oblique intertrochanteric fractures can be effectively treated with third generation intramedullary nails. More screw migration was seen in PFNA than Intertan nails after the operation in this study.

Intertrochanteric Femoral Fractures: A Comparison of Clinical and Radiographic Results with the Proximal Femoral Intramedullary Nail (PROFIN), the Anti-Rotation Proximal Femoral Nail (A-PFN), and the InterTAN Nail

“…HHS was the most reported functional outcome for patients with intertrochanteric fractures, as reported in multiple studies [ 33 , 34 , 35 , 36 , 37 , 38 , 39 ], and in these reports, no statistically significant differences in HHS were found among PFN groups. Similar to the current study, a 2015 study by Uzer et al [ 12 ] compared HHS values between patients who had InterTAN and PROFIN nails and found no significant difference.…”

Barriers and facilitators of weight bearing after hip fracture surgery among older adults. A scoping review

“…We included 69 studies reflecting a total of 48,978 patients with sample sizes ranging from 28 [35] to 13,939 [36]. Fifty-one studies were observational and 18 studies were randomised clinical trials, which compared different surgical procedures.…”

“…For comparisons of different internal fixation procedures, intramedullary implant facilitators included the intramedullary nail with auxiliary locking plate (compared with intramedullary nail with steel wire) [93], Proximal femoral nail antirotating (PFNA) with cerclage cables (compared with PFNA alone) [63], intramedullary nail with cerclage cable (compared with intramedullary nail alone) [91], and PFNA-II (compared with interTan and profn nails) [57]. The interTan and PFNA [35,83], and pertrochanteric nails and PFNA [79] were not associated with weight bearing. Extramedullary implant facilitators included dynamic compression locking system (DCLS) (compared with multiple cannulated compression screw (MCCS)) [84], percutaneous compression plate (PCCP) (compared with Dynamic hip screw (DHS)) [80], DHS with scaffold enriched with the autologous bone marrow stem cells concentrate (compared with DHS alone) [92], and Medoff sliding plate (MSP) (compared with Dynamic condylar screw, DHS and DHS with trochanteric stabilizing plate) [73].…”

Stabilisation of AO OTA 31-A unstable proximal femoral fractures: Does the choice of intramedullary nail affect the incidence of post-operative complications? A systematic literature review and meta-analysis

“…The most frequently reported functional outcome was the Harris Hip Score (HHS) with ten studies reporting this outcome for patients with unstable fractures [12,15,16,18,[37][38][39]41,43,44] . No significant differences were seen between groups for HHS for any comparison (data not shown, p = 0.18 for INTERTAN vs other IM nails in unstable fractures).…”