Comparison of Two Types of Proximal Femoral Nails in the Treatment of Intertrochanteric Femur Fractures

Uzer, Gökçer; Elmadağ, Nuh Mehmet; Yıldız, Fatih; Bilsel, Kerem; Erden, Tunay; Toprak, Hüseyin

doi:10.5505/tjtes.2015.72173

Cited by 14 publications

(14 citation statements)

References 22 publications

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“…[16] The results of a study that compared PFN with 1 and 2 lag screws showed that 2 lag screws yielded better results in patients with good bone quality but had a higher cut-out risk in patients with osteoporosis. [17] Uzer et al [18] compared functional and radiological results as well as complication rates in patients treated with PFN using an integrated, interlocking, compression lag screw and 2 separate lag screws. They found no statistically significant differences in the functional and radiological results or complication rates in the treatment of intertrochanteric femur fractures.…”

Section: Discussionmentioning

confidence: 99%

Treatment of intertrochanteric femur fractures in the elderly via bipolar hip arthroplasty or proximal femoral nail

Korkmaz¹

2018

South Clin Ist Euras

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Objective: There is a debate about the treatment of intertrochanteric femur fractures in the geriatric population. A proximal femoral nail (PFN), a sliding hip screw, and bipolar hip arthroplasty (BHA) are the most commonly used treatment modalities. The aim of this study was to compare the blood transfusion rate, duration of surgery, and clinical scores of elderly patients treated with cementless BHA and a PFN. Methods:A total of 38 patients with intertrochanteric femur fractures treated with cementless BHA or a PFN between 2012-2016 were evaluated. In all, 20 patients had surgical treatment with cementless BHA and 18 had surgical treatment with a PFN. All of the patients were evaluated with the Harris Hip Score (HHS) at the last control visit. Blood transfusion rates and the duration of surgery were recorded and the values of both groups were compared statistically. Results:The mean HHS was 81.4±10.5 for the BHA group and 83.7±13 for the PFN group. The mean blood transfusion volume was 1.45±0.6 units for the BHA group and 0.33±0.48 units for the group treated with a PFN. The mean duration of surgery for the BHA group was 95±23.1 minutes. In the PFN group, the mean duration of the surgery was 61.8±7.3 minutes. Conclusion:There was a significant difference in the duration of surgery and the blood transfusion volume. The PFN procedure takes less time than BHA, and the blood transfusion volume is smaller. For these reasons, PFN seems to be a better option than BHA.

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Section: Discussionmentioning

confidence: 99%

Treatment of intertrochanteric femur fractures in the elderly via bipolar hip arthroplasty or proximal femoral nail

Korkmaz¹

2018

South Clin Ist Euras

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“…Fusion rate was 87-100 %, the nonunion rate was 3-13%, malunion rate was 3-6%, and implant failure rate was 0-4% in the first and second generation CMNs [9,11]. The disadvantages of IMNs were the high frequency of need for intraoperative fluoroscopic imaging, difficulties in techniques in implementation, the need for experienced surgeons, the difficulty in implant removal in need, and implantation difficulty especially in fractures extending trochanter major and fossa piriformis [7,9,10,12]. High level of complication rates after surgical fixation in unstable proximal femur fracture in elder patients brought up primary hip prosthesis implementation [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…The mean age was 60, but the age interval was 19-90. In the surgical method of implant selection in unstable proximal femur fractures, many treatment methods were suggested in the past, and there were still discussions about that [2][3][4][7][8][9][10]. In one of them that is 95 degree wedged condylar plates, fusion rate had been found 92-100 %, malunion was 13-24%, the late union was 6-19%, nonunion was 3-12%, and implant failure was 6-24% [9].…”

Section: Discussionmentioning

confidence: 99%

Comparison of locking plate and cephalomedullary nailing in unstable proximal femur fractures

Öztürk¹

2018

Ann Clin Anal Med

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Aim: The aim of this study is to compare the treatment results of unstable pertrochanteric femur fractures with proximal femur locking plates (PFLP) and cephalomedullary nailing (CMN). Material and Method: Between 2012 -2016, 36 patients (with mean age 60.1 +/-19.9 std) (between 18-90) of which 25 were male (%69) and 11 were female (%31) were retrospectively analyzed. Patients were divided into two groups. There were 12 patients in the first group who undergone CMN, and there were 24 patients in the second group who undergone PFLP. Results: The proximal lateral cortex fracture occurred in one patient of CMN group, fusion was achieved in 11 patients (91%). In PFLP group, mechanic failure occurred in one patient, pseudoarthrosis occurred in one patient, and fusion was achieved in 22 patients (91,6%). There was no infection in CMN group, and in PFLP group infection was seen in 3 patients (12,5%) of which 2 were deep and 1 was a superficial infection. DVT occurred in 2 patient in CMN (16,6%) and 1 patient in PFLP group (4,1%). Discussion: CMN and PFLP treatment results in patients with unstable femur pertrochanteric fractures were both satisfactory; surgery time, peroperative blood transfusion need, postoperative hospitalization time, mechanical failure and reoperation rates were similar.

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“…PFs are surgically treated with a closed reduction and internal fixation (CRIF) osteosynthesis by a cervical-cephalic nail or a sliding hip screw [5][6][7][8][9][10][11][12][13]. Intramedullary nail is the preferred synthesis because it allows a reduction of the time of surgery, a stable synthesis and an early patient mobilization [14]. In particular, these considerations are valid for more stable PFs, classified with AO/OTA [15] pattern 31-A1 (pertrochanteric simple) and 31-A2 (pertrochanteric multifragmentary).…”

Section: Introductionmentioning

confidence: 99%

Intramedullary nailing for pertrochanteric fractures of proximal femur: a consecutive series of 323 patients treated with two devices

et al. 2019

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Introduction: Pertrochanteric fractures (PFs) frequently affect the lower limb of osteoporotic patients and represent an important cause of morbidity and mortality in the elderly. In this prospective randomized controlled trial, we have compared functional and radiological results and complications of patients affected by PFs treated with two intramedullary proximal femoral nails. Materials: We enrolled 323 subjects with PFs, classified according to AO/OTA system as 31.A1 (pertrochanteric simple) and 31.A2 (pertrochanteric multifragmentary). Patients were divided into two groups according to the osteosynthesis devices: group A, Elos-Intrauma® nail (155 cases) and group B, Gamma 3-Stryker® nail (168 cases). Pre-operatively, the baseline characteristics of each patient (gender, age, weight and BMI) were collected. Intraoperative blood loss, subjective pain by visual analogue scale (VAS), esthetic satisfaction, functional scores of the hip by Harris Hip Score (HHS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were noted. The post-operative degree of fracture reduction was assessed. Each patient had a minimum follow-up of 12 months. Results: The study group was composed of 106 male and 217 female with an average age of 85.4 (range, 65-90, standard deviation (SD) 5.95) years. No statistical differences about sex and age distribution were noted between the two groups. Group A reported lower intraoperative blood loss, 45 ml vs 51 ml, respectively (p < 0.001). There was not any statistical difference about operative time. Group A had a better reduction of fracture (p = 0.0347). The greatest difference was detectable comparing subgroups 31.A2 (p = 0.032). There were no statistical differences about complication frequency and the overall rate was 25% (80 cases). Finally, there was no difference in terms of VAS, HHS, and WOMAC score between the two groups on each follow-up. Patients of group A showed a higher subjective satisfaction index at 1 post-operative year, 7.42 (SD 1.19) vs 6.45 (SD 1.35) of group B (p < 0.001). Conclusion: Elos® nail is a reliable device on a short-term follow-up and represents an alternative choice to the Gamma 3® nail, a well-known and appreciated system for over 25 years.

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Comparison of Two Types of Proximal Femoral Nails in the Treatment of Intertrochanteric Femur Fractures

Cited by 14 publications

References 22 publications

Treatment of intertrochanteric femur fractures in the elderly via bipolar hip arthroplasty or proximal femoral nail

Treatment of intertrochanteric femur fractures in the elderly via bipolar hip arthroplasty or proximal femoral nail

Comparison of locking plate and cephalomedullary nailing in unstable proximal femur fractures

Intramedullary nailing for pertrochanteric fractures of proximal femur: a consecutive series of 323 patients treated with two devices

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