Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: A systematic review of 13,568 patients

Norris, Rory; Bhattacharjee, Dhritiman; Parker, Martyn J.

doi:10.1016/j.injury.2011.10.027

Cited by 129 publications

(57 citation statements)

References 69 publications

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“…The first generation IMHS was fraught with technical complications [2,9,10]. Even with the advances in nail design and increased familiarity among surgeons, problems such as lag screw cut-out [11,12], peri-implant fracture [13], implant failure [14], and trochanteric pain [12], have been reported.…”

Section: Introductionmentioning

confidence: 99%

Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture

O’Malley

Kang

Azer

et al. 2015

Arch Orthop Trauma Surg

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Section: Introductionmentioning

confidence: 99%

Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture

O’Malley

Kang

Azer

et al. 2015

Arch Orthop Trauma Surg

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“…But for stable fractures, the stress placed on locking screws is little and therefore related complications are rare. 1,19,27 Other complications, such as hip pain, distal tip fractures, lag screw cut-out, nonunion, DVT and wound infection, indicated no substantial association with the DL screws. They might be influenced by the option of nailing devices, patients' co-morbidities, medical levels in different regions and other factors.…”

Section: Discussionmentioning

confidence: 99%

Distal locked or unlocked nailing for stable intertrochanteric fractures? A meta‐analysis

Yan

Cao

Sun

et al. 2019

ANZ Journal of Surgery

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Background To date, there are just several studies comparing distal locked nails with distal unlocked nails in treating intertrochanteric fractures. We report the first meta‐analysis about this issue. Methods Systematic search was conducted for studies in PubMed, Embase and Cochrane Library. Meta‐analyses were performed regarding intra operative outcomes, complications and functional outcomes. Results Pooled results showed insignificant difference between distal locking group and distal unlocking group in hip pain (relative risk (RR) 1.14, 95% confidence interval (CI) 0.59–2.19), distal tip fracture (RR 1.08, 95% CI 0.37–3.11), lag screw cut‐out (RR 1.60, 95% CI 0.54–4.78), delayed or nonunion (RR 1.32, 95% CI 0.25–7.06), deep vein thrombosis (RR 1.06, 95% CI 0.23–4.84), wound infection (RR 0.58, 95% CI 0.28–1.22), Harris hip score (standard mean deviation (SMD) 0.03, 95% CI −0.15 to 0.21) and walking ability. However, significant difference was detected in operation time (SMD 0.77, 95% CI 0.36–1.17), fluoroscopy exposure time (SMD 1.02, 95% CI 0.52–1.52), blood loss (SMD 0.80, 95% CI 0.62–0.99) and total incision length (SMD 1.16, 95% CI 0.86–1.47). Result of trial sequential analysis indicated conclusive evidence. Conclusion Current evidence indicates that the distal locked intramedullary nails should not be recommended as routine choice for stable intertrochanteric fractures.

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“…Thus, the use of intramedullary nails is not considered to be a genuine minimally invasive treatment. Although the technology of the intramedullary nail has been continuously improved, the systematic review by Norris et al (32) reported that the incidence of a second fracture after internal fixation with an intramedullary nail was approximately 1.7%.…”

Section: Discussionmentioning

confidence: 99%

Treatment of AO/OTA 31-A3 intertrochanteric femoral fractures with a percutaneous compression plate

Luo

Shen

et al. 2014

Clinics

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OBJECTIVE:AO/OTA 31-A3 intertrochanteric femoral fractures have completely different fracture line directions and biomechanical characteristics compared with other types of intertrochanteric fractures. The choice of the fixation method has been a focus of dispute among orthopedic trauma surgeons. The purpose of this study was to review the outcomes of these fractures treated with a percutaneous compression plate at our institute.METHOD:Seventeen patients with AO/OTA 31-A3 intertrochanteric femoral fractures were treated with a percutaneous compression plate at our institute from January 2010 to December 2011. The clinical data and imaging results were retrospectively analyzed.RESULTS:The medical complication of popliteal vein thrombosis occurred in one patient. Sixteen patients were followed up for 12 to 21 months. Two patients had malunion and mild pain. Fracture collapse occurred in two patients, with one having head penetration. These two patients had moderate pain. There were no occurrences of nonunion or reoperation. The mean Harris hip score obtained during the last follow-up was 84.1 (61-97). Patients with a poor quality of reduction were more likely to have pain results (p = 0.001). A trend existed toward the presence of a poor quality of reduction (p = 0.05) in patients with a collapse of fracture. Patients with poor preoperative mobility were more likely to have a lower Harris hip score (p = 0.000).CONCLUSION:The percutaneous compression plate is an alternative device for the treatment of AO/OTA 31-A3 intertrochanteric femoral fractures. Good fracture reduction and an ideal placement position of the neck screw are important in the success of the device.

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Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: A systematic review of 13,568 patients

Cited by 129 publications

References 69 publications

Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture

Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture

Distal locked or unlocked nailing for stable intertrochanteric fractures? A meta‐analysis

Treatment of AO/OTA 31-A3 intertrochanteric femoral fractures with a percutaneous compression plate

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