A new device designed by aoasif, the pfna proximal femoral nail antirotation, represents a unique intramedullary nail system for improved management, particularly in the elderly. See the guidelines for authors for a complete description of levels of evidence. The purpose of this metaanalysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate. A subtrochanteric intramedullary rod for use in fracture fixation in the femur characterized in that it is fluted throughout its length and has a minor portion of a diameter greater than its major portion, thereby being of stepped configuration. Trochanteric femoral nail how is trochanteric femoral.
Gamma3 nail 180 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. Pdf proximal femoral nail for treatment of trochanteric. Technical difficulties and results in trochanteric fractures 235. This study evaluated the feasibility of a helixshaped femoral nail that would facilitate ease of nail insertion through the trochanter and save implant removal along a helical pathway.
Although there were several reports showing benefits of proximal femoral nail 1618, it was still associated with technical failures 19, 20. Request pdf greater trochanteric versus piriformis fossa entry nails for femur shaft fractures. Health, general fracture fixation equipment and supplies methods fracture repair hip fractures care and treatment hip joint fractures orthopedic. Complications following treatment of trochanteric fractures. The helical blade should be centered in the ap and lateral views of the femoral head. Trochanteric buttress plate, lateral wall comminution of greater trochanter, unstable trochanteric fracture, screw migration, cut out of screw 1. Trochanteric femoral nail surgical technique depuy synthes trauma 5 3 determine ccd angle instruments 03. Attach the helical blade to the helical blade inserter. Sixtyone consecutive patients with femoral shaft fractures 50 closed and 11 open fractures treated with antegrade nailing with insertion through the greater trochanter. Trochanteric locking nail in elderly subjects, fractures, and proximal femoral fractures in particular, are becoming more frequent in france, in parallel with lifeexpectancy 1, 2. The trochanteric femoral nail tfn is a recently introduced intramedullary system, designed to improve treatment of intertrochanteric fractures of the hip. A recommendation for using long femoral stems may be one way to reduce the risk for reoperations. Trigen metatan trochanteric antegrade nail provides both stability and versatility for high proximal fractures, midshaft fractures, distal fractures. Piriformis fossa nail if using the piriformis fossa nail, the entry point is between the top of the femoral neck and bottom of the piriformis fossa.
In a clinical study, the intraoperative use, complications and outcome of. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. The new fluted sub trochanteric nail system or rod disclosed herein is designed to provide an entirely intramedullary device for the fixation of sub trochanteric fractures which can be inserted via a closed or blind procedure, or via an open procedure without the necessity of xray surveillance, with only a minimal surgical exposure and not. Herzog bend and standard trochanteric entry for femoral lengthening in children. Gamma3 nail 170 the anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. Aug 20, 20 the trochanteric im nail is a useful implant for treating femoral shaft fractures. Trochanteric entry nailing for pediatric femoral shaft fractures. Trochanteric entry nailing for pediatric femoral shaft fractures j. Smith definition fractures of the femoral shaft are characterized by acute, nonpathologic fractures of the femur in which the primary portion of the fracture is at least 5 cm distal to the lesser trochanter and at least as far proximal to the. Treatment of trochanteric fractures with the pfna proximal. Femur t2 gtn knifelight greater trochanter entry carpal.
Outcome of trochanteric femoral fracture treatment with. Intraoperative closed reduction and percutaneus fixation of. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis. The aim of the present study was to analyze the results of treatment with pfna in 50 patients with trochanteric fractures. Gamma3 long nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10cm proximal to the intracondylar notch including fractures of the basilar neck, intertrochanteric fractures, peritrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. Panchanadikar v 2016 proximal femur nail in intertrochanteric fractures indications and tipstricks. However, technical difficulties and implant related complications have been described with this technique, thus we need more studies to address these issues. The failure of devices intended to repair trochanteric fractures, such as the gamma locking nail gln, might be related to reduced bone desity. The sgn had a mediolateral curvature of 10 that differed from the trochantertodiaphysis angle in an average patient. All randomized controlled trials comparing proximal femoral nail and. Resolving the controversy background intramedullary nailing is the treatment of. Twenty five patients suffering from unstable trochanteric and subtrochanteric fractures for 30 months from july 2012 to december 2014.
Trochanteric nail if using the trochanteric nail, the entry point is at the tip of the greater trochanter, in line with the femur on the lateral radiograph. Trochanteric femoral nail can be abbreviated as tfn. Proximal femoral nail is a better choice of implant for the treatment of an unstable trochanteric fracture, however it is associated with screw migration and cutout because of greater trochanteric comminution and coronal split. Proximal femoral nail for treatment of trochanteric femoral fractures article pdf available in journal of orthopaedic surgery hong kong 153. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients j. Also with limited access approach, one can reduce the blood loss, soft tissue trauma and infection. Subtrochanteric femoral fracture during trochanteric nailing. Complications in trochanteric and subtrochanteric femoral. Trochanteric locking nail versus arthroplasty in unstable. Gadegone 1, bhaskaran shivashankar 2, vijayanad lokhande 3 and yogesh salphale 3 1 department of orthopaedic and traumatology, associate professor of orthopaedics, gmc, 442402 chandrapur, maharashtra, india. In the following, the trochanteric nail 180 is called. Mechanical failures after fixation with proximal femoral nail.
The trigen metatan trochanteric antegrade nail is indicated for fractures of the femur including simple long bone fractures, severely comminuted, spiral, large oblique and segmental fractures. Gamma3 trochanteric nail 180 cambridge orthopaedics. The proximal femoral nail pfn introduced by the aoasif group in 1998 has become prevalent in treating trochanteric fractures in recent years 1215. Augmentation of proximal femoral nail in unstable trochanteric fractures wasudeo m.
Besides the t2 femoral nail with a 3m radius of curvature, stryker offers also a 1. Trochanteric nail insertion for the treatment of femoral. Proximal femoral nail versus dynamic hip screw fixation for. Fides trochanteric nail system trochanteric nail 120 125 5 universal anatomical shape distal dynamization is possible greater strength and stability compared with the side plate lag screw to transfer the load of the femoral head into the nail shaft by bridging the fracture line. Gamma3 nail 180 all nails use the same lag screws, set screw, distal locking screws and end caps see fig. First, the proper starting point for trochanteric nailing is just lateral to the long axis of the femur. Resolving the controversy background intramedullary nailing is the treatment of choice for shaft.
Trochanteric nail insertion for the treatment of femoral sha. Clinical report by bulletin of the nyu hospital for joint diseases. Trochanteric femoral fractures are frequently associated with severe osteoporosis in elderly patients. The distal ends of the flutes in each of the major and minor portions have sharp points thereon adapted to cut into bone and means are. Proximal femoral nailing in communited intertrochanteric fractures is increasingly becoming popular in view of superior biomechanics and prevention of varus collapse associated with dynamic hip screw. Subtrochanteric femoral fracture during trochanteric. The low rates of femoral shaft fractures and failure of fixation suggest the proximal femoral nail is useful for treatment of unstable trochanteric and subtrochanteric fractures. Greater trochanteric versus piriformis fossa entry nails for. Proximal femur nail in intertrochanteric fractures.
Cai 1department of orthopedic surgery, shanghai tenth peoples hospital, tongji university, school of medicine, shanghai, china. The meaning of tfn abbreviation is trochanteric femoral nail. The trochanteric im nail is a useful implant for treating femoral shaft fractures. Tfn titanium trochanteric fixation nail system surgical technique depuy synthes 9 preoperative implant selection use the ao preoperative planner rulers for the titanium trochanteric fixation nail system to determine nail length, nail diameter, femoral neck angle and head element length. X yaozeng, g dechun, y huilin, z guangming, w xianbincomparative study of trochanteric fracture treated with the proximal femoral nail antirotation and the third generation of gamma nail injury, 41 12 2010, pp. Trochanteric entry for femoral lengthening nails in. Gamma3 nail 170 all nails use the same lag screws, set screw, distal locking screws and end caps see fig. Titanium trochanteric fixation nail system instrument assembly blade guide sleeve, for trochanteric fixation nails 357.
Intraoperative closed reduction and percutaneus fixation. Is the proximal femoral nail a suitable implant for. Proximal femoral nail antirotation versus gamma3 nail for. The intramedullary proximal femoral nail was devised by the aoasif group in 1996 with two proximal screws including an antirotation screw with the aim of. Prognosis is poor, in as much as associated general health status is impaired by numerous comorbidities 3.
Phoenix antegrade femoral nail system featuring corelock. Treatment of trochanteric fractures with the pfna proximal femoral nail antirotation nail system. This study is to evaluate the results of trochanteric buttress plate tbp combined with pfn in an. The purpose of this study is to determine whether trochanteric entry im lengthening nails can be used safely no avn or proximal femoral deformity in the skeletally immature femur. Zeffect and reverse zeffect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails pfn comprising two interlocking head screws.
Introduction in an unstable trochanteric fractures intact lateral wall plays a key role instabilization of fracture by proximal femoral nail. This website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to you by collecting statistical information. Mechanical failures after fixation with proximal femoral. Osteoporosis may also influence pain and walking ability because of low stability in the fracture area. Reason and treatment of failure of proximal femoral nail. Select a guide wire and insert the guide wire in line. Earlier results with gamma nail did not produce any sig.
Orthopedics a technique for dosed intraoperative reduction of comminuted displaced femoral neck fractures with the trochanteric gamma nail is described. Titanium trochanteric fixation nail system quick reference chart. Various intramedullary devices such as gamma nail, proximal femoral nail, proximal femoral nail antirotation, and intertan integrated nail have been used for fixation of these fractures. Titanium trochanteric fixation nail system quick reference. Gamma3 trochanteric nail 180 hip fracture operative technique. The t2 gtn system is one of the first femoral nailing systems to offer an option for tip of greater trochanteric entry point insertion with the option to apply compression either by an external compression device or by an internal compression screw. Trochanteric buttress plate combined with proximal femoral. All cases of unstable trochanteric and subtrochanteric fractures operated by proximal femoral nail during this time period were taken up for study, which were studied prospectively after taking due consent.
Tfnadvanced proximal femoral nailing system tfna the tfna system is designed to advance the treatment of trochanteric fractures by providing surgical options that help to preserve bone in insertion area due to reduced critical width, improve anatomical fit 1 and increase implant strength. Intertrochanteric fracture treated with tfn trochanteric femoral nail. The following surgical procedures should be considered for the trochanteric nailing of femoral shaft fractures to prevent implantderived complications. Mar 01, 2003 orthopedics a technique for dosed intraoperative reduction of comminuted displaced femoral neck fractures with the trochanteric gamma nail is described. Jul 22, 2016 trochanteric entry nailing for pediatric femoral shaft fractures j. Proximal femoral nail versus dynamic hip screw fixation. This study is to evaluate the results of trochanteric buttress plate tbp combined with pfn in an unstable it fractures for buttressing lateral wall. Trochanteric femoral nail how is trochanteric femoral nail abbreviated. The head element should be centered in the ap and lateral.
Trochanteric entry nailing for pediatric femoral shaft. Greater trochanteric versus piriformis fossa entry nails. U in the following, the trochanteric nail 170 is called. Failure of fixation of trochanteric femur fractures. Study of clinical and functional outcome of unstable. Insert blade guide sleeve assembly through the aiming arm. In study ii, a retrospective cohort study, 987 patients operated with an intramedullary nail due to an unstable trochanteric or subtrochanteric hip fracture at sos, between january 1, 2011 and december 31, 20 were analysed.
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