Favorable radiographic outcomes using the expandable proximal femoral nail in the treatment of hip fractures – A randomized controlled trial

Chechik, Ofir; Amar, Eyal; Khashan, Morsi; Pritsch, Tamir; Drexler, Michael; Goldstein, Yariv; Steinberg, Ely L.

doi:10.1016/j.jor.2014.04.004

Cited by 11 publications

(19 citation statements)

References 31 publications

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“…The purpose behind this is maximizing clinical results in patients of pertrochanteric patents both throughout their life and at injury time. 1,3,25 Dynamic hip screw has always remained conventional implant for the stabilization of fractures among patients with pertrochanteric hip fractures. However, the advent of PFN has revolutionized pertrochanteric fractures with established benefits of increased stability, decreased operative blood loss and early mobilization.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In elder age, pertrochanteric fractures of the proximal femur occurs very commonly. 3 With the advanced age in populations, it is expected that its incidence will rise even more. 2 Loss of independence, high rates of morbidity and mortality are associated with these fractures.…”

Section: Introductionmentioning

confidence: 99%

“…2 Loss of independence, high rates of morbidity and mortality are associated with these fractures. 3,4,5 Almost all cases need surgical fixation and at present there are lots of options for fixation of these fractures. 3 The Dynamic Hip Screw (DHS) is one of such devices that allow controlled dynamic sliding of the lag screw over the barrel of the side plate and allows dynamic compression while weightbearing to stabilize the femur so that it may undergo remodeling and proper fracture healing.…”

Section: Introductionmentioning

confidence: 99%

“…6 Though in treating fractures of proximal femur, this device is taken as gold standard yet numerous new devices are also available in the market with improved outcomes. 3 Proximal femoral nail (PFN) is the latest and the best implant for unstable intertrochanteric femoral fractures. Potential advantages of this cephalomedullary device are efficient load transfer and shorter lever arm which results in less transfer of the stress & less implant failures with added advantage of rotation control.…”

Section: Introductionmentioning

confidence: 99%

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Comparison between Dynamic Hip Screw and Proximal Femoral Nail in Patients with Pertrochanteric Fractures

Habib

Khan

Rakha

2020

APMC

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Objective: To compare dynamic hip screw and proximal femoral nail in patients with pertrochanteric fractures in terms of frequency of infection and union. Study Design: It was a randomized controlled trial. Settings: This study was carried at Department of Orthopedic Surgery, DHQ Teaching Hospital Faisalabad-Pakistan. Duration: 1 year from March 2017 to March 2018. Methodology: This study involved 60 patients belonging both genders having age between 20-70 years undergoing pertrochanteric fracture surgery. By random division of these patients, two treatment groups were made; Group-A (n=30) patients underwent fracture fixation with DHS while those in Group-B (n=30) were treated with proximal femoral nailing. Outcome variable was frequency of infection (diagnosed clinically upon appearance of any two of the following signs within 4 weeks after operation; redness around the wound, serosangious discharge and fever >100 o F) and union (clinical and radiological) at 12 weeks follow-up that was noted for making comparison between the two groups. A written informed consent was taken from all the participating patients. Results: The mean age of the patients was 54.80±8.57 years. There was a female predominance with male to female ratio of 1:1.4. The frequency of union was significantly higher (86.7% vs. 46.7%; p=0.001) while the frequency of infection was significantly lower (0.0% vs. 30.0%; p<0.001) in patients managed with PFN as compared to conventional practice of DHS regardless of patient's age and gender. Conclusion: Proximal femoral nail was found superior to DHS in terms of significantly higher frequency of union and decreased risk of infection in patients with pertrochanteric fractures regardless of patient's age and gender which advocates preferred use of proximal femoral nail in future practice provided the necessary hardware and surgical skills are available.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison between Dynamic Hip Screw and Proximal Femoral Nail in Patients with Pertrochanteric Fractures

Habib

Khan

Rakha

2020

APMC

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“…For trochanteric fractures, with the development of new generation PFNs, and studies showing more favorable results in terms of functional results, operative duration, blood loss, hospital stay and being less invasive, PFN has become a more widely adopted technique than older techniques such as dynamic hip screw (DHS) systems. [ 6 ]…”

Section: Introductionmentioning

confidence: 99%

The effect of surgical technique on cognitive function in elderly patients with hip fractures: Proximal femoral nailing versus hemiarthroplasty

Sürücü

Aydın²,

Gürcan³

et al. 2022

Jt Dis Relat Surg

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Hip fractures are as common as 100 to 500/100,000 individuals in the elderly population, resulting in increased mortality and morbidity following the fractures and their treatments. [1][2][3] For the patients over the age of 65 years, intracapsular fractures like femoral head and neck fractures are commonly treated with hemiarthroplasty (HA), and extracapsular fractures such as trochanteric fractures with proximal femoral nailing (PFN). [4,5] Open reduction and internal fixation for femoral head and neck fractures are preferred for non-displaced stable fractures in younger population. For trochanteric fractures, with the development of new generation PFNs, and studies showing more favorable results in terms of functional results, Objectives: This study aims to compare the effects of hemiarthroplasty (HA) and proximal femoral nailing (PFN) on postoperative cognitive function in elderly adults with hip fractures.Patients and methods: Between August 2021 and January 2022, a total of 49 patients (28 males, 21 females; mean age: 78.1±9.4 years; range, 65 to 96 years) presented with a proximal femoral fracture were included. The patients were divided into two groups based on the type of surgical technique used. Group 1 consisted of 23 patients who underwent cemented HA, while Group 2 consisted of 26 patients who underwent osteosynthesis with a PFN. Preoperatively (24 h before surgery), within the first week (Days 4 to 7), and at one month following surgery, the Mini-Mental State Examination (MMSE) was applied. Results:The surgery side and duration of surgery were not significantly different between the two groups (p>0.05); however, the length of hospital stay and estimated blood loss were significantly different (p<0.001) in favor of Group 2. When the decline in MMSE scores from preoperative to postoperative was assessed, it was shown that Group 2 had a lesser decrease. Conclusion:Patients with hip fractures who underwent PFN surgery experienced less postoperative cognitive impairment than those who underwent HA surgery.

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Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults

Lewis

Macey

Gill

et al. 2022

Cochrane Database of Systematic Reviews

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BackgroundHip fractures are a major healthcare problem, presenting a substantial challenge and burden to patients, healthcare systems and society. The increased proportion of older adults in the world population means that the absolute number of hip fractures is rising rapidly across the globe. Most hip fractures are treated surgically. This Cochrane Review evaluates evidence for implants used to treat extracapsular hip fractures. Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults (Review)

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Favorable radiographic outcomes using the expandable proximal femoral nail in the treatment of hip fractures – A randomized controlled trial

Abstract: Conclusion: EPFN provides stable fixation of pertrochanteric hip fractures and prevents neck shortening that is commonly observed after DHS fixation.

Cited by 11 publications

References 31 publications

Comparison between Dynamic Hip Screw and Proximal Femoral Nail in Patients with Pertrochanteric Fractures

Comparison between Dynamic Hip Screw and Proximal Femoral Nail in Patients with Pertrochanteric Fractures

The effect of surgical technique on cognitive function in elderly patients with hip fractures: Proximal femoral nailing versus hemiarthroplasty

Cephalomedullary nails versus extramedullary implants for extracapsular hip fractures in older adults

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