Is proximal femoral nailing a good procedure for teaching in orthogeriatrics?

Biber, Roland; Grüninger, Sebastian; Singler, Katrin; Sieber, Cornel; Bail, Hermann Josef

doi:10.1007/s00402-012-1511-x

Cited by 21 publications

(13 citation statements)

References 11 publications

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“…These two factors are closely related to the surgeon's experience and skill; Biber et al [27] showed that the risk of screw cutout is increased with inexperienced surgeons.…”

Section: Discussionmentioning

confidence: 98%

Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study

Seyhan

Türkmen

Unay

et al. 2015

Journal of Orthopaedic Science

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“…These two factors are closely related to the surgeon's experience and skill; Biber et al [27] showed that the risk of screw cutout is increased with inexperienced surgeons.…”

Section: Discussionmentioning

confidence: 98%

Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study

Seyhan

Türkmen

Unay

et al. 2015

Journal of Orthopaedic Science

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“…Complications in the surgical treatment of elderly patients' hip fractures are frequent, with rates ranging from 8 to 40% according to the current literature [1,2,3,4,5]. In addition, the long-term results following hip fracture surgery are poor, including the loss of independence in approximately half of the cases [6] and mortality rates of up to 37% over the first year following surgery [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Bliemel

Lechler

Oberkircher

et al. 2015

Dement Geriatr Cogn Disord

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Objective: To examine the influence of cognitive impairment on the functional outcomes and complication rates of patients with hip fracture during in-patient treatment. Methods: A total of 402 patients who were surgically treated for hip fractures were consecutively enrolled at a single trauma center. The patients were grouped according to their results on the Mini-Mental State Examination (MMSE), i.e., ≥20 points (group I) and ≤19 points (group II). Complication and in-hospital mortality rates as well as postoperative functional outcomes according to the Barthel Index (BI) were compared between the groups. A multivariate regression analysis was performed to control for additional factors. Results: 33% of the patients had MMSE scores ≤19 points. The complication rates were similar between the groups (p > 0.05). Likewise, the overall in-hospital mortality rates were similar between the patients in group I (4.5%) and those in group II (9.8%; β = 0.218, p < 0.740). Functional outcomes, as assessed by the BI, were lower in group II (β = -0.266, p < 0.001). The patients in group II were transferred to a rehabilitation clinic less frequently (52.3 vs. 76.0%, p < 0.001). Conclusions: Patients with lower MMSE scores are at a higher risk for poorer functional outcomes. Perioperative care should focus on the preservation of functional abilities to protect these patients from an additional loss of independence and disadvantageous clinical course.

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“…In response to such problem, bone cement-enhanced PFNA designs with perforated spiral blades may provide stronger fixation of fractured femoral head-neck ends, none of 59 patients was found to undergo screw cutouts, cut through, blade displacement, implant loosening or disruption during a mean follow-up of 4 months [33]. It should be pointed out that inadequate surgeon experience may also increase the risk of screw cutout [34].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes with proximal femoral nail anti-rotation versus InterTAN nail for intertrochanteric femoral fractures: A meta-analysis

Liu

2020

Preprint

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Objective: To access the efficacy and safety of proximal femoral nail anti-rotation (PFNA) and InterTAN nail for intertrochanteric femoral fractures.Methods: According to the Cochrane systemic analysis method, randomized control trials (RCTs) and retrospective comparative observational studies which were related to the comparison of PFNA and InterTAN nail in the treatment of the elderly with intertrochanteric fractures were retrieved. Data were independently extracted from the included studies by two reviewers and analyzed using RevMan 5.3 , and the quality of the studies was assessed.Results: Two RCTs and seven observational studies were recruited, which consisted of 681 patients with PFNA and 651 patients with InterTAN nail. The meta-analyses showed no significant differences between the two approaches on Harris Hip Score, operation time, blood loss, time to union, mean hospital stay, union problems, intraoperative complications, hematoma, infection, other complication in both RCTs and observational studies. In terms of other outcomes, for the RCTs, results showed that there were shorter tip–apex distance, reduced pain at thigh or hip in InterTAN nail than in PFNA; however, InterTAN nail was not superior to PFNA in cutout, reoperation, and femoral shaft fracture; for observational studies, the risk of the screw migration (RR=5.13, 95%CI: [1.33,19.75], P=0.02), cutout (RR=3.26, 95%CI: [1.64,6.47], P=0.0008), the varus collapse of the femoral head (RR=7.19, 95%CI: [2.18,23.76], P=0.001), femoral shaft fracture (RR=5.73, 95%CI: [2.24,14.65], P=0.0003) treated by InterTAN nail were significantly decreased, compared with those by PFNA; however, no significant differences was observed in the aspects of tip–apex distance and pain at thigh or hip between these two groups.Conclusion: Analysis of a large number of relevant clinical indicators available shows that InterTAN nail has better clinical manifestation than PFNA in treating unstable femoral intertrochanteric fractures.

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Is proximal femoral nailing a good procedure for teaching in orthogeriatrics?

Abstract: We conclude that proximal femoral nailing is an operation suitable for teaching purposes. However, patients between 71 and 80 years of age seem to be at an increased risk for cut-out if operated by a resident.

Cited by 21 publications

References 11 publications

Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study

Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study

Effect of Preexisting Cognitive Impairment on In-Patient Treatment and Discharge Management among Elderly Patients with Hip Fractures

Comparison of clinical outcomes with proximal femoral nail anti-rotation versus InterTAN nail for intertrochanteric femoral fractures: A meta-analysis

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