Evaluation of the long intra-medullary hip screw

Hamilton, R.J.; Kelly, I.G.

doi:10.1016/j.injury.2003.12.011

Cited by 14 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These have previously been used to treat subtrochanteric and high-energy proximal femoral fractures to good effect. 9,13,20 To the best of our knowledge, no previous study has assessed the use of the Holland nail in the treatment of intertrochanteric fractures.…”

Section: Discussionmentioning

confidence: 99%

A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip

Little

Verma

Fernando

et al. 2008

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

We compared the outcome of patients treated for an intertrochanteric fracture of the femoral neck with a locked, long intramedullary nail with those treated with a dynamic hip screw (DHS) in a prospective randomised study. Each patient who presented with an extra-capsular hip fracture was randomised to operative stabilisation with either a long intramedullary Holland nail or a DHS. We treated 92 patients with a Holland nail and 98 with a DHS. Pre-operative variables included the Mini Mental test score, patient mobility, fracture pattern and American Society of Anesthesiologists grading. Peri-operative variables were anaesthetic time, operating time, radiation time and blood loss. Post-operative variables were time to mobilising with a frame, wound infection, time to discharge, time to fracture union, and mortality. We found no significant difference in the pre-operative variables. The mean anaesthetic and operation times were shorter in the DHS group than in the Holland nail group (29.7 vs 40.4 minutes, p < 0.001; and 40.3 vs 54 minutes, p < 0.001, respectively). There was an increased mean blood loss within the DHS group versus the Holland nail group (160 ml vs 78 ml, respectively, p < 0.001). The mean time to mobilisation with a frame was shorter in the Holland nail group (DHS 4.3 days, Holland nail 3.6 days, p = 0.012). More patients needed a post-operative blood transfusion in the DHS group (23 vs seven, p = 0.003) and the mean radiation time was shorter in this group (DHS 0.9 minutes vs Holland nail 1.56 minutes, p < 0.001). The screw of the DHS cut out in two patients, one of whom underwent revision to a Holland nail. There were no revisions in the Holland nail group. All fractures in both groups were united when followed up after one year. We conclude that the DHS can be implanted more quickly and with less exposure to radiation than the Holland nail. However, the resultant blood loss and need for transfusion is greater. The Holland nail allows patients to mobilise faster and to a greater extent. We have therefore adopted the Holland nail as our preferred method of treating intertrochanteric fractures of the hip.

show abstract

Section: Discussionmentioning

confidence: 99%

A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip

Little

Verma

Fernando

et al. 2008

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

show abstract

“…1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In younger patients, the cephalomedullary nail may be used for unstable fractures of the proximal femur as well.…”

mentioning

confidence: 99%

Early complications associated with cephalomedullary nail for intertrochanteric hip fractures

Erez

Dougherty

2012

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

BACKGROUND: Use of cephalomedullary devices for pertrochanteric fractures has been associated with complications of cutout, fracture distal to the tip of the implant, infection, and hardware failure. The goal of recent design changes (a trapezoidal shape of the proximal device, with interdigitation of the cephalocervical screws) in cephalomedullary nails was to improve fracture fixation and stability of pertrochanteric fractures. This is a retrospective review of the first 127 surgeries using this new cephalomedullary nail to review early complications seen with this device. METHODS:A review of early complications (cutout, infection, fracture distal to the tip, fracture collapse, and hardware failure) for 100 patients who met inclusion criteria was performed. RESULTS:Postoperative mechanical complications included six (6%) patients with significant collapse of the femoral neck, six (6%) fractures distal to the implant (short nail only, n ϭ 75), one (1%) cutout, four (4%) infections, and one (1%) implant breakage. The implant breakage occurred at the screw-nail interface. CONCLUSION: In our study population, we found this newer cephalomedullary device had complications similar to those reported with devices in previous studies. (J Trauma. 2012;72: E101-E105.

show abstract

“…The protrusion of the screws from the lateral region and their migration into the joint can cause abnormal pain and reduce the extent of joint movement, accounting for some of the complications of this treatment. On the other hand, 20% of patients undergoing intramedullary fixation may need reoperation (20,21). In this study, the mean age of the patients was 42.7 ± 16.2 years, which shows that most of the ST fractures were caused by high-energy traumas mostly occurring in young people.…”

Section: Discussionmentioning

confidence: 60%

Comparison of Proximal Femur Locking Compression Plate and Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

et al. 2019

View full text Add to dashboard Cite

Background: The sub-trochanteric (ST) fracture is relatively common. It does not have a single treatment but it can be repaired in a variety of ways. Objectives: The aim of this study was to compare the proximal femur locking compression plate (PFLCP) and intramedullary nailing in the treatment of ST fracture. Methods: This cross-sectional study was performed on 56 patients with ST fracture who referred to Firoozgar Hospital, Tehran, Iran, between January 2014 and December 2018. The patients were equally divided into two groups, PFLCP group and nailing group. The recovery and postoperative complications were evaluated by the Harris hip score (HHS). Results: Of the 56 eligible patients examined, 49 (87.5%) were male. The overall mean age was 42.7 ± 16.2 years. The status of the union was significantly better in the PFLCP group than in the nailing group (P = 0.038). The total mean HHS was 88.9 ± 14.1 with no significant difference between the two groups. The results of the logistic regression model showed that sex and age could significantly decrease the HHS. Thus, the HHS was influenced by female sex (OR = 0.851) and age of more than 60 (OR = 0.829). Conclusions: PFLCP provides an appropriate union, expedites the operation, and yields a very good HHS. Therefore, it can work even better than intramedullary nailing in some parameters, such as pain after the operation.

show abstract

Evaluation of the long intra-medullary hip screw

Cited by 14 publications

References 21 publications

A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip

A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip

Early complications associated with cephalomedullary nail for intertrochanteric hip fractures

Comparison of Proximal Femur Locking Compression Plate and Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

Contact Info

Product

Resources

About