The AO/ASIF proximal femoral nail (PFN) for the treatment of unstable trochanteric femoral fracture

Al-Yassari, Ghassan; Langstaff, R. J.; Jones, Jenna; Al-Lami, M

doi:10.1016/s0020-1383(02)00008-6

Cited by 171 publications

(85 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[9][10][11] The patients treated with PFN were able to walk earlier than those treated by DHS as reported by many studies. 6,8,12 This finding was also seen in our study.…”

supporting

confidence: 91%

“…6 PFN gives biomechanically stable construct allowing early weight bearing in unstable trochanteric fractures. 7,8 Many studies recommended PFN for the surgical treatment of unstable trochanteric fractures as controlled compression of fracture occurs without rotational malalignment of the fracture fragments. [9][10][11] The patients treated with PFN were able to walk earlier than those treated by DHS as reported by many studies.…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2016

View full text Add to dashboard Cite

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.

show abstract

“…[9][10][11] The patients treated with PFN were able to walk earlier than those treated by DHS as reported by many studies. 6,8,12 This finding was also seen in our study.…”

supporting

confidence: 91%

mentioning

confidence: 99%

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

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The standard of peritrochanteric fracture treatment is stable fixation, which allows early full weightbearing mobilization of the patient [1,5,10,24,27]. The choice of surgical treatment is determined in part by whether the fracture is judged stable or unstable.…”

Section: Introductionmentioning

confidence: 99%

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

Macheras

Koutsostathis

Galanakos

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

“…Appropriate treatment of this fracture is must to prevent these complications [2,3] . Literature says that about 15 to 20 % of elderly patients with Intertrochantric fractures dies within one year of injury if no appropriate treatment is given [4] . Previously these fractures are treated conservatively with traction and prolonged bed rest for 10 to 12 weeks followed by ambulation training.…”

Section: Introductionmentioning

confidence: 99%

Functional and radiological outcome of intertrochanteric fracture in patients treated with dynamic hip screw and proximal femoral nail

M¹,

P²,

Dalton³

et al. 2017

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Background: The aim of the study was to assess the functional and radiological outcome of intertrochanteric fracture in elderly patients treated with dynamic hip screw or proximal femoral nail Materials and Methods: The study was conducted in Government Stanley hospital, from May 2014 to December 2015. A total of 98 cases of intertrochanteric fractures in age group of 55 to 65 years admitted were included in our study. Patients with pathological fracture was excluded. The 98 patients were divided into stable and unstable groups using Evans classification. DHS was done for 56 of them and PFN for another 42 of them and results were evaluated. The mean duration of surgery, mean blood loss and mean length of incision, intraoperative complications, time of weight bearing were evaluated. The Harris hip score was used to evaluate the hip joint function. Results: Most of the patients in our age group were between 55 to 65 years around 80%. The mean duration of surgery, mean blood loss and mean length of incision was more in DHS group then PFN group. We came across more intraoperative complications in PFN group then DHS group. Time of weight bearing was more in unstable fracture in DHS group. The Harris hip score was in favour of PFN at six weeks after surgery but it became same in both groups after 20 weeks of surgery Conclusion: PFN has advantage of smaller incision, less blood loss and less morbidity. The short lever arm and lower bending moment in PFN may add mechanical advantage to the construct which makes it the implant of choice in osteoporotic bones. Deformity and complications was less in PFN group in our study. Rate of fracture union was similar in both groups with early mobilization in PFN group, DHS found to be the implant of choice for stable fracture but for unstable fracture PFN is the better choice.

show abstract

The AO/ASIF proximal femoral nail (PFN) for the treatment of unstable trochanteric femoral fracture

Cited by 171 publications

References 10 publications

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

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

Does PFNA II Avoid Lateral Cortex Impingement for Unstable Peritrochanteric Fractures?

Functional and radiological outcome of intertrochanteric fracture in patients treated with dynamic hip screw and proximal femoral nail

Contact Info

Product

Resources

About