Mustafa Seyhan1, Ismail Turkmen2, Koray Unay3, Afsar Timucin Ozkut4. 1. Department of Orthopaedic and Traumatology, Kadikoy Acibadem Hospital, Istanbul, Turkey. mustafa.seyhan@acibadem.com.tr. 2. Department of Orthopaedics and Traumatology, Istanbul Beykoz State Hospital, Pasabahce D.H. Beykoz, Istanbul, Turkey. dr.ismailturkmen@gmail.com. 3. Department of Orthopaedics and Traumatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey. kunay69@yahoo.com. 4. Department of Orthopaedics and Traumatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey. afsarozkut@superonline.com.
Abstract
OBJECTIVE: To clinically and radiologically compare third-generation intramedullary nails used in the treatment of trochanteric hip fractures and to determine their efficacy. MATERIALS AND METHODS: Seventy-five of 88 patients admitted to our hospital with trochanteric fractures were enrolled in the study; 43 were treated with PFNA devices and 32 with Intertan nails. The amount of compression applied during the procedure, duration of the procedure, amount of subsequent shortening in the proximal femoral area, subsequent backup of proximal screws, and changes in the tip-apex and tip-cortex distances were compared between groups. The postoperative change in the varus angle of the proximal femur and times to mobilization, full weight bearing, and fracture union were also evaluated. RESULTS: On early postoperative radiographs, the tip-apex distance was ≤25 mm in 86 % of patients in the PFNA group and 96.9 % of those in the Intertan group. Twelve months postoperatively, the tip-apex distance did not differ between groups. No cut-out of the screws into the coxofemoral joint was observed. Fracture healing was achieved in all patients. At 12 months postoperatively, the rates of proximal screw backup, proximal femoral shortening, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. CONCLUSIONS: Trochanteric fractures may be treated effectively with PFNA devices or Intertan nails. During the healing period, the rates of reverse displacement of the proximal screw, shortening of the proximal femur, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Surgical technique, implant positioning, and the choice of implant play roles in the successful treatment of trochanteric fractures. LEVEL OF EVIDENCE: Level 1, prospective, prognostic study.
OBJECTIVE: To clinically and radiologically compare third-generation intramedullary nails used in the treatment of trochanteric hip fractures and to determine their efficacy. MATERIALS AND METHODS: Seventy-five of 88 patients admitted to our hospital with trochanteric fractures were enrolled in the study; 43 were treated with PFNA devices and 32 with Intertan nails. The amount of compression applied during the procedure, duration of the procedure, amount of subsequent shortening in the proximal femoral area, subsequent backup of proximal screws, and changes in the tip-apex and tip-cortex distances were compared between groups. The postoperative change in the varus angle of the proximal femur and times to mobilization, full weight bearing, and fracture union were also evaluated. RESULTS: On early postoperative radiographs, the tip-apex distance was ≤25 mm in 86 % of patients in the PFNA group and 96.9 % of those in the Intertan group. Twelve months postoperatively, the tip-apex distance did not differ between groups. No cut-out of the screws into the coxofemoral joint was observed. Fracture healing was achieved in all patients. At 12 months postoperatively, the rates of proximal screw backup, proximal femoral shortening, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. CONCLUSIONS: Trochanteric fractures may be treated effectively with PFNA devices or Intertan nails. During the healing period, the rates of reverse displacement of the proximal screw, shortening of the proximal femur, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Surgical technique, implant positioning, and the choice of implant play roles in the successful treatment of trochanteric fractures. LEVEL OF EVIDENCE: Level 1, prospective, prognostic study.
Authors: Sharon R Lewis; Richard Macey; Joseph Lewis; Jamie Stokes; James R Gill; Jonathan A Cook; William Gp Eardley; Martyn J Parker; Xavier L Griffin Journal: Cochrane Database Syst Rev Date: 2022-02-10
Authors: Xianshang Zeng; Nan Zhang; Dan Zeng; Lili Zhang; Ping Xu; Lei Cao; Weiguang Yu; Ke Zhan; Xinchao Zhang Journal: J Int Med Res Date: 2017-04-18 Impact factor: 1.671
Authors: Chi Zhang; Bo Xu; Guanzhao Liang; Xianshang Zeng; Dan Zeng; Deng Chen; Zhe Ge; Weiguang Yu; Xinchao Zhang Journal: J Int Med Res Date: 2018-03-08 Impact factor: 1.671
Authors: Hui Zhang; Xianshang Zeng; Nan Zhang; Dan Zeng; Ping Xu; Lili Zhang; Deng Chen; Weiguang Yu; Xinchao Zhang Journal: J Int Med Res Date: 2017-06-06 Impact factor: 1.671