Proximal femoral nailing is better choice in treatment of intertrochanteric fracture in elderly people

Myderrizi, Neritan

doi:10.18203/2349-2902.isj20161153

Cited by 10 publications

(22 citation statements)

References 2 publications

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“…In contrast many studies have reported the incidence to be more common in females. 3,16,17 The most common type of fracture (31A2) however was similar to that in the previous studies. 18 Since there are two proximal screws in the implant under study, we cannot measure accurately the tip apex distance (TAD).…”

Section: Discussionsupporting

confidence: 87%

“…Also malunion, varus deformity and limb shortening are common along with bed sores. 3 The primary goal of fracture treatment is to return the patient to his/her prefracture level of function while mobilising the elderly patient as soon as possible. Many different surgical procedures and implants have been described for fixation of intertrochanteric fractures like plate and screw constructs, either nail or screws for the head fixation, nail constructs with either nail or screws, external fixation, and arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

Rathore¹,

Gupta²,

Thakur³

et al. 2018

Int J Res Orthop

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Background: Intertrochanteric fracture is common injury and is found in both elderly and the young. Proximal femoral nail (PFN) has been in widespread use for the same in the recent past. There are advocates both for and against this implant. The aim was to study the results of PFN in the treatment of intertrochanteric fractures and their functional evaluation using the modified Harris hip score.Methods: A prospective study done on 104 patients operated for intertrochanteric fractures with PFN. Patients were followed up at 6 weekly intervals and evaluated at each visit using the modified Harris hip score (HHS).Results: The study consisted of 104 patients aged from 36 to 96 years with average age of 67.8 years. Most patients belonged to 60-80 years category. Malunion was observed in three patients (2.8%) and non union was not seen in any patient. Excellent to good results were seen in 73% patients 18% patients had a fair outcome, 7.7% had poor and 2% patients had very poor outcome.Conclusions: PFN is a good implant for intertrochanteric fracture treatment that demands a sound technique and a good reduction prior to insertion. The assessment of results using HHS has been too similar to those obtained using Kyle’s criteria in the previous studies, proving its role in the same.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

Rathore¹,

Gupta²,

Thakur³

et al. 2018

Int J Res Orthop

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“…Anatomical fracture reduction was found in 90% of the patients and full weight bearing stability was achieved in 92%. In our study acceptable anatomical reduction was obtained in 85% cases but we open reduced two fracture [21] . An intraoperative fracture displacement during manual introduction of the nail into the femoral shaft has not been reported with the gamma nail but this has been a problem with the PFN.…”

Section: Discussionmentioning

confidence: 49%

Evaluation of peritrochanteric fractures of femur with proximal femoral nail: A prospective study

Lokesh¹,

Kurupati²,

Srinivas³

et al. 2019

Int. J. Orthop. Sci.

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Peritrochanteric fractures of femur are most commonly encountered fractures in orthopaedic practice which can be treated by various modalities of management each having its own advantages and disadvantages. With advent of PFN we are able to overcome most of the complications associated with other modalities. The aim of the study is to analyze clinical, functional & radiological outcomes of peritrochanteric fractures of femur managed with proximal femoral nail and were followed up until complete fracture union. The patients were assessed periodically with HARRIS HIP SCORE. 12 patients had excellent results, 28 patients had good results, 5 patients had fair results and 5 patients had poor. Based on our study we found PFN is an ideal modality of management of peritrochanteric fractures of femur.

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“…9 Functional score in patients treated with PFN was better than DHS in the first 3 months. 15 Patients who were treated by PFN restored walking ability earlier as compared to those treated by DHS. 6 Our study results were similar to above study findings.…”

mentioning

confidence: 92%

Randomized comparative study to evaluate the role of proximal femoral nail and dynamic hip screw in unstable trochanteric fractures

et al. 2016

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INTRODUCTIONThe stability of the trochanteric fracture depends on the amount of contact between the proximal and distal main fragments. Trochanteric fractures with comminution of posteromedial buttress exceeding simple lesser trochanteric fragment or with subtrochanteric extension are termed as unstable. In 3-part fractures stability is inversely proportional to the size of the lesser trochanteric fragment. Instability occurs when more than 50% of the calcar is affected allowing the proximal fragment to collapse into varus with shortening. Reverse obliquity fracture is unstable fracture in which major fracture line extends outward and downward from the lesser trochanter.Unstable trochanteric fractures are technically much more challenging than stable fractures. Stable reduction of an intertrochanteric fracture requires providing medial and posterior cortical contact between the major proximal and distal fragment to resist varus and posterior displacing forces. For unstable fractures intramedullary implants are (biomechanically) superior.1 Lag screw cut-out failure following fixation of unstable intertrochanteric fractures in osteoporotic bone remains an unsolved challenge. 2 ABSTRACTBackground: Treatment of unstable trochanteric fracture is much more challenging than stable fracture. These fractures require stable fixation to minimize the fracture and implant related complications. Need of this study is to assess the suitable implant for stable fixation of unstable trochanteric fracture with less intra and postoperative complications and good functional outcome. Methods: In this prospective randomized comparative study, 64 patients were distributed into two groups. Group A consisted of patients treated by proximal femoral nail (PFN) (n=32) and group B treated by dynamic hip screw (DHS) (n=32). All the patients were evaluated preoperatively and surgery was done according to the group they were allotted. Post-operative follow up was done at 6 weeks, 3, 6 and 12 months. Results: Average age of the patients in this study was 51.26±10.24 year. In this study patients were followed up for an average of 10.87±2.61 month. The duration of surgery was shorter in PFN group. Weight bearing was earlier in PFN group than DHS group. Mean functional ability score was better in PFN group with significant gain in function earlier as compared to DHS group. Conclusions: PFN is a better implant for internal fixation of unstable trochanteric fractures which allows early mobilization and has got better functional outcome score in early postoperative period than DHS.

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Proximal femoral nailing is better choice in treatment of intertrochanteric fracture in elderly people

Cited by 10 publications

References 2 publications

Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

Evaluation of peritrochanteric fractures of femur with proximal femoral nail: A prospective study

Randomized comparative study to evaluate the role of proximal femoral nail and dynamic hip screw in unstable trochanteric fractures

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