Evaluation of clinical results and complications of internal fixation of intertrochanteric femur fracture with proximal femoral nail antirotation (original) (raw)
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Journal of Chittagong Medical College Teachers' Association
Background: The aim of this study is to evaluate the management of intertrochanteric fracture of the femur using Proximal Femoral Nail Antirotation (PFNA). Materials and methods: Sixty patients of unstable pertrochanteric fractures were treated by closed reduction and internal fixation by proximal femoral nail antirotation from July 2015 to June 2017. Four patients were lost to follow-ups. The remaining 56 patients were followed for a mean period of 2 years. The results were evaluated by assessing the patients regarding their clinical and functional outcome at follow up as per kyle’s criteria Results: Peroperative failure to proximal head neck blade fixation (n-1) jamming of nail (n=2) and post operative lateral migration of head neck blade (n=1) and fracture related infection (n=1) were complications observed. End results were excellent in 46.34%, good in 36.58%, fair is 14.64% and poor in 2.43%. Conclusion: Proximal Femoral Nail Antirotation (PFNA) is the biomechanically and biolo...
2020
Objective: To analyze the early outcomes of treatment with proximal femoral nail antirotation (PFNA) in patients with unstable intertrochanteric femoral fracture.Study Design: Retrospective cross-section study. Place and Duration of Study: Pakistan Naval Ship (PNS) Shifa Hospital Karachi, from Jan 2015 to Dec 2016. Methodology: Non-probability convenience sampling was used to include unstable intertrochanteric femoral fractures which were treated with proximal femoral nail antirotation. Outcomes were measured in terms of operating time, per-operative blood loss, postoperative weight bearing and complications. Results: A total of 35 patients were analyzed. Mean age was 69.7 years (range 48-91, standard deviation (SD) ± 2.28). There were 18 males (51.4%) and 17 females (48.6%) patients. Majority of fractures were Arbeitsgemeinschaft fur Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF) type 3-1-A-2.3 and were seen in 16 patients (45.7%). Average operative ti...
International Journal of Orthopaedics Sciences, 2019
Background: Intertrochanteric fractures of the femur are fairly common injuries seen in Orthopaedic practice and have a bimodal age distribution. Various modalities of treatment are available in the management of these fractures. The aim of this study was to evaluate the role of the proximal femoral nail (PFN) in the management of these fractures and to assess the functional outcome using the Harris hip score. Methods: 30 patients with Intertrochanteric fractures of the femur who were willing for surgery and follow up were included in our study and were treated with proximal femoral nail and were followed up for a 3 year period. Results: There was a male preponderance seen in our study with the right hip being more commonly affected. The most common mode of injury was slip and fall followed by road traffic accidents. The mean surgical time was 59.03 minutes and the average time to fracture union was 12.4 weeks. The mean Harris hip score was 83.3 and we had excellent results in 5 patients and good results in 12 of them. Conclusion: Proximal femoral nailing is an effective treatment option in the management of intertrochanteric fractures of the femur and is associated with lesser operating times, minimal blood loss and earlier weight bearing as compared to other fixation methods and rehabilitation of the patients is quite rapid as well leading to a good functional outcome.
Outcome of intertrochanteric fracture managed with proximal femoral nail antirotation 2
Asian Journal of Medical Sciences
Background: Intertrochanteric fracture is a common condition seen in elderly population which is managed with operative procedure in the department of orthopedics. The proximal femoral nail antirotation (PFNA) system was developed by the AO/ASIF in 2004 for this fracture that provides optimal anchoring and stability when the implant is inserted into the osteoporotic bone. The main characteristic of the implant is the use of a single blade with a large surface area and insertion of the blade compacts the cancellous bone. Aims and Objectives: The aim of the study was to study the functional outcome of intertrochanteric fracture managed with PFNA2. Materials and Methods: The prospective and observational study was conducted in patients diagnosed with intertrochanteric fracture admitted in orthopedic ward, Western Regional Hospital, Pokhara. Pre- and post-operative fracture alignment, Harris hip score (HHS), post-operative complications were taken into account. Results: Out of 55 cases ...
IOSR Journals , 2019
Introduction: Intertrochanteric femur fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to trivial trauma. Age of patient, osteoporosis, general health, associated co-morbidities are some of the key factors to be considered for the successful treatment of these fractures. Materials and Methods: In our institution, we have selected 24 cases of unstable intertrochanteric fractures for this prospective study. All cases enrolled were managed with the proximal femoral nail. These cases were studied from the mechanism of injury, classification, and treatment with the proximal femoral nail and their surgical and functional outcome with or without residual comp. Results: Patients were followed up for an average period of 8.58 months. The mean Harris hip score was 88.75 at 6th month. The score was excellent in 12 patients, good in 10 patients, fair in 1 patient and poor in 1 patient. In our study of 24 patients with unstable intertrochanteric fracture, the average age incidence was 54.64 years. In the present study male: female was 5:3. Conclusion: In unstable proximal femur fractures, PFN is a significant advancement in the treatment of unstable trochanteric fractures which has the unique advantages of closed reduction, preservation of fracture hematoma, less tissue damage, early rehabilitation and early return to work.
Functional Outcome in Intertrochanteric Femur Fracture Fixation using Proximal Femur Nail
MVP Journal of Medical Sciences
Background: This study was conducted to assess the functional outcome of Proximal Femoral Nailing in fixation of Intertrochanteric fractures of Femur. Methods: After obtaining written consent, this prospective study was conducted among 127 patients (age group>18 years) who had inter-trochanteric fracture with or without subtrochanteric extension fixed using proximal femoral nail. Mobilisation was started between first week to 6th week of fracture fixation depending on the rigidity of fixation and pain tolerance of the patient. Patients were followed up at 6th week, 3rd month and 6th month after operative fixation. Functional outcome was assessed using a physician based scoring system i.e. Harris Hip Score at every follow up. Scores were tabulated and assessment was done. Results: The present study included, 54 females (42.5%) and 73 males (57.5%) in the age group of 28 years to 94 years with the mean age of 67.7 years. Unstable inter-trochanteric fractures were seen in 106 cases ...
Outcome and complications of intertrochanteric femur fractures treated by proximal femoral nail
International Journal of Orthopaedics Sciences, 2019
Purpose: This study was done to report the functional outcome and the complications of intertrochanteric fractures fixed with Proximal Femoral Nail (PFN) in Indian population. Methods: 124 patients with intertrochanteric fractures fixed with PFN and with a minimum follow-up of 4 months were assessed. Functional outcome was calculated using Modified Harris Hip Score (HHS) and Parkers Mobility Score (PMS). Radiological outcome was assessed using hip radiographs and complications encountered during the follow-up period were noted. Results: 117 patients had a good functional outcome with mean HHS of 71.2 and PMS 7.09. During first year, outcome and recovery was better for AO 31A1 and 31A2 fractures (p < 0.05). After one year, no difference was seen in outcome between fracture types. Patients less than 60 years had better outcome than those above 60 years (p < 0.05). Three patients expired during follow-up period. Nine patients had implant related complications with four of them re...
International journal of health sciences
Background: Intertrochanteric Femur Fractures are usually complicated withassociated co-morbidities like osteoporosis, diabetes, hypertension, renal failure. In suchcircumstances, nonoperative treatment is mainly reserved for poor medical candidates and non-ambulantpatients with minimal discomfort after fracture. Objective: To study the management of intertrochanteric fractures with proximal femoral nail anti-rotation-II. Material and Methods: Present study was conducted on the patients admitted in at BTGH attached to MR medical college, Kalburgi &Shri B M Patil Medical College Hospital and Research Centre, Vijayapura,with diagnosis of intertrochanteric fractures from October 2017 to April 2019. A total of 21 cases were taken in our study. Results: Majority of the cases i.e., 12(60%) were in the age group of 61- 80 years, followed by 3 cases in the age group 41-60 years. The mean age was 69years. Majority of the patients were males 13 (65%) and 7 (35%) were females. We took less num...
Journal of clinical and diagnostic research : JCDR, 2017
Management of unstable intertrochanteric fractures poses challenges in terms of obtaining stable fixation and good postoperative outcomes. There is a paucity of clinical data comparing the commonly used Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation (PFNA) implants, especially in relation to osteoporosis. To assess comparative performance of PFN and PFNA in the setting of osteoporosis. Patients presenting with unstable intertrochanteric fractures (AO 31.A2 and 31.A3) were included and treated with either PFN or PFNA. Preoperative radiographs of normal side were used to grade osteoporosis by Singh's index. Grade 3 or less was considered significant. Postoperative radiographs were assessed for tip-apex distance, Cleveland index and quality of reduction. Patients were followed up for a minimum of nine months and any complications noted. Comparison of functional outcomes was done using the Harris Hip Score and Parker-Palmer mobility score at final follow up. Stat...
Advances in Orthopedics
Background. Proximal femoral nail antirotation-2 (PFNA-2) has been widely used to treat intertrochanteric fractures with varied outcomes in the previous studies. The entry point of the nail plays an important role in achieving acceptable reduction, stable fixation, and avoiding implant related complications. This study was proposed to determine the optimal greater trochanteric entry point for PFNA-2 in unstable intertrochanteric femur fractures. Methods. We conducted an observational study on 40 patients with unstable intertrochanteric fracture treated with PFNA-2 implant in a tertiary care hospital. The patients were grouped into two based on the entry point: group L for lateral and group M for medial entry. Randomization was carried out by assigning the patients to the group by alternate allocation. The quality of reduction, tip apex distance, Cleveland index, and all the complications were noted. The final follow-up was conducted at six months. The functional outcome was evaluate...