Removal of a broken trigen intertan intertrochanteric antegrade nail

Zheng, Xuan-Lin; Park, Kyeong-Hyeon; Kim, Sung-Min; An, Haemosu; Yang, Kyu Hyun

doi:10.1016/j.injury.2016.12.014

Cited by 17 publications

(16 citation statements)

References 13 publications

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“…A recent publication by Zheng et al 9) reported about the difficulty in removing the lag screw secondary to breakage of an integrated compression screw of a Trigen intertan nail (Smith & Nephew). This reported mechanical failure was also associated with the breakage of the nail at the lag screw hole site.…”

Section: Discussionmentioning

confidence: 99%

Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes

et al. 2017

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Proximal femoral cephalomedullary nailing is one of the treatments of choice for intertrochanteric fracture. Zimmer Natural Nail® (ZNN; Zimmer) is one of the alternatives. We report two cases of broken tail portion of the ZNN lag screw during the removal procedure. This may be the first reported cases in scientific literature with this pattern of failure. We report these cases to highlight one of the possible problems that could occur during removal of this implant which can possibly prolong the operation time significantly if the required device is not prepared.

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Section: Discussionmentioning

confidence: 99%

Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes

et al. 2017

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“…Dynamic hip screws in extramedullary fixation have been widely used and were considered as the gold standard for extracapsular fractures previously [ 4 ]. However, multiple meta-analyses have shown that intramedullary fixation, compared with extramedullary fixation, could benefit the patient in terms of reduced risk of implant failure and reoperation, as well as improved functional scores [ 6 – 8 ]. PFNA is a kind of intramedullary fixation with a large area of spiral blade, which can achieve tighter bone compaction and femur alignment than traditional screws, providing optimal anchoring and stability for intertrochanteric fractures [ 2 , 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…PFNA is a kind of intramedullary fixation with a large area of spiral blade, which can achieve tighter bone compaction and femur alignment than traditional screws, providing optimal anchoring and stability for intertrochanteric fractures [ 2 , 9 – 11 ]. In addition, InterTAN nail, as another type of intramedullary fixation, uses an integrated interlocking lag nail system that can better limit the movement of the femoral head and can effectively avoid the collapse of the femoral head [ 6 , 12 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

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

Liu

2020

J Orthop Surg Res

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Background A meta-analysis to access the pros and cons of proximal femoral nail anti-rotation (PFNA) versus InterTAN nail for intertrochanteric femoral fractures including available evidence extracted from literature. 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, and other complications in both RCTs and observational studies. In terms of other outcomes, for the RCTs, results showed that there were shorter tip–apex distance and 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 were 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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“…Dynamic hip screws in extramedullary fixation has been widely used and was considered as the gold standard for extracapsular fractures previously [4]. However, with the recent advances in materials and technology for intramedullary fixation devices, various intramedullary fixations favored by surgeons, especially young doctors, have proven to be safe and effective intraoperatively, and they have become the main treatment method for intertrochanteric fractures [6]. Multiple meta-analyses have shown that intramedullary fixation, compared with extramedullary fixation, is beneficial for patients with unstable femoral intertrochanteric fractures, allowing for reduced risk of implant failure and reoperation rates, and improved postoperative functional scores [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, InterTAN nail, as another type of intramedullary fixation, uses an integrated interlocking lag nail system in which the main tension screw and the compression screw are trapezoidal in outline. The advantages of such design are to limit movement of the femoral head, reduce fracture fragments, decrease the loss of fracture reduction during surgery, and avoid the collapse of the femoral head [6,12,13]. These two kinds of third-generation intramedullary nails avoid the "Z" effect, which often occurs in the second-generation intramedullary nails [14].…”

Section: Introductionmentioning

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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Removal of a broken trigen intertan intertrochanteric antegrade nail

Cited by 17 publications

References 13 publications

Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes

Breakage of the Tail Portion of the Lag Screw during Removal of Proximal Femoral Zimmer Natural Nail: Report of Two Cases with Technical Notes

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

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

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