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Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 7/2019

30.05.2019 | Original Article • HIP - TRAUMA

The impact of proximal femoral nail type on clinical and radiological outcomes in the treatment of intertrochanteric femur fractures: a comparative study

verfasst von: Altuğ Duramaz, Mehmet Hakan İlter

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 7/2019

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Abstract

Purpose

The aim of the study was to compare three different proximal femoral nails in terms of functional and radiological outcomes in patients treated with closed reduction and internal fixation for intertrochanteric femur fractures (IFFs).

Methods

Between February 2010 and March 2016, 303 consecutive patients (132 male, 171 female) were included in the study. The groups were compared in terms of age, gender, body mass index, duration of surgery and duration of fluoroscopy, blood loss, type of fracture and quality of the reduction, complication rate, and functional and radiological results. Harris hip score (HHS), Barthel index, and full weight bearing time were used for functional evaluation. The quality of the reduction, collodiaphyseal angle (CDA), tip–apex distance (TAD), and fracture union were used for radiological results evaluation.

Results

There was no significant difference between groups in terms of fracture type, reduction quality, and complication rates. The mean operation time, duration of scopy, blood loss, and TAD was higher for InterTan, whereas the mean postoperative CDA was higher for PFNA-II. Operation time, postoperative CDA, and full weight bearing duration were higher for Profin than for InterTan. The mean HHS and Barthel Index were higher for PFNA-II, while the mean duration of operation and fluoroscopy, blood loss, TAD, and full weight bearing time were higher for Profin.

Conclusion

PFNA-II is a better option than Profin and InterTAN in the treatment of IFFs when the surgical parameters and functional and radiological results were evaluated as a whole.
Literatur
1.
Zurück zum Zitat Bjørgul K, Reikerås O (2007) Incidence of hip fracture in southeastern Norway: a study of 1730 cervical and trochanteric fractures. Int Orthop 31:665–669CrossRef Bjørgul K, Reikerås O (2007) Incidence of hip fracture in southeastern Norway: a study of 1730 cervical and trochanteric fractures. Int Orthop 31:665–669CrossRef
2.
Zurück zum Zitat Wild M, Jungbluth P, Thelen S, Laffrée Q, Gehrmann S, Betsch M et al (2010) The dynamics of proximal femoral nails: a clinical comparison between PFNA and Targon PF. Orthopedics 33(8):398–404 Wild M, Jungbluth P, Thelen S, Laffrée Q, Gehrmann S, Betsch M et al (2010) The dynamics of proximal femoral nails: a clinical comparison between PFNA and Targon PF. Orthopedics 33(8):398–404
3.
Zurück zum Zitat Xu Z, Zhang M, Yin J, Ren L, Zeng Y (2015) Redisplacement after reduction with intramedullary nails in surgery of intertrochanteric fracture: cause analysis and preventive measures. Arch Orthop Trauma Surg 135(6):751–758CrossRef Xu Z, Zhang M, Yin J, Ren L, Zeng Y (2015) Redisplacement after reduction with intramedullary nails in surgery of intertrochanteric fracture: cause analysis and preventive measures. Arch Orthop Trauma Surg 135(6):751–758CrossRef
4.
Zurück zum Zitat Parker MJ, Handoll HH (2010) Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev 8(9):CD000093 Parker MJ, Handoll HH (2010) Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev 8(9):CD000093
5.
Zurück zum Zitat Soucanye de Landevoisin E, Bertani A, Candoni P, Charpail C, Demortiere E (2012) Proximal femoral nail antirotation (PFN-ATM) fixation of extra-capsular proximal femoral fractures in the elderly: retrospective study in 102 patients. Orthop Traumatol Surg Res 98:288–295CrossRef Soucanye de Landevoisin E, Bertani A, Candoni P, Charpail C, Demortiere E (2012) Proximal femoral nail antirotation (PFN-ATM) fixation of extra-capsular proximal femoral fractures in the elderly: retrospective study in 102 patients. Orthop Traumatol Surg Res 98:288–295CrossRef
6.
Zurück zum Zitat Uzer G, Elmadağ NM, Yıldız F, Bilsel K, Erden T, Toprak H (2015) Comparison of two types of proximal femoral hails in the treatment of intertrochanteric femur fractures. Ulus Travma Acil Cerrahi Derg 21(5):385–391PubMed Uzer G, Elmadağ NM, Yıldız F, Bilsel K, Erden T, Toprak H (2015) Comparison of two types of proximal femoral hails in the treatment of intertrochanteric femur fractures. Ulus Travma Acil Cerrahi Derg 21(5):385–391PubMed
7.
Zurück zum Zitat Kucukdeveci AA, Yavuzer G, Tennant A, Suldur N, Sonel B, Arasil T (2000) Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med 32:87–92CrossRef Kucukdeveci AA, Yavuzer G, Tennant A, Suldur N, Sonel B, Arasil T (2000) Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med 32:87–92CrossRef
8.
Zurück zum Zitat Fogagnolo F, Kfuri M Jr, Paccola CA (2004) Intramedullary fixation of pertrochanteric hip fractures with the short AO/ASIF proximal femoral nail. Arch Orthop Trauma Surg 124:31–37CrossRef Fogagnolo F, Kfuri M Jr, Paccola CA (2004) Intramedullary fixation of pertrochanteric hip fractures with the short AO/ASIF proximal femoral nail. Arch Orthop Trauma Surg 124:31–37CrossRef
9.
Zurück zum Zitat Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM (1995) The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am 77:1058–1064CrossRef Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM (1995) The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am 77:1058–1064CrossRef
10.
Zurück zum Zitat Kouvidis G, Sakellariou VI, Mavrogenis AF, Stavrakakis J, Kampas D, Galanakis J et al (2012) Dual lag screw cephalomedullary nail versus the classic sliding hip screw for the stabilization of intertrochanteric fractures. A prospective randomized study. Strateg Trauma Limb Reconstr 7:155–162CrossRef Kouvidis G, Sakellariou VI, Mavrogenis AF, Stavrakakis J, Kampas D, Galanakis J et al (2012) Dual lag screw cephalomedullary nail versus the classic sliding hip screw for the stabilization of intertrochanteric fractures. A prospective randomized study. Strateg Trauma Limb Reconstr 7:155–162CrossRef
11.
Zurück zum Zitat Kumbaraci M, Karapinar L, Turgut A (2017) Comparison of second and third-generation nails in the treatment of intertrochanteric fracture: screws versus helical blades. Eurasian J Med 49(1):7CrossRef Kumbaraci M, Karapinar L, Turgut A (2017) Comparison of second and third-generation nails in the treatment of intertrochanteric fracture: screws versus helical blades. Eurasian J Med 49(1):7CrossRef
12.
Zurück zum Zitat Stern R, Lübbeke A, Suva D, Miozzari H, Hoffmeyer P (2011) Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures. Int Orthop 35:1855–1861CrossRef Stern R, Lübbeke A, Suva D, Miozzari H, Hoffmeyer P (2011) Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures. Int Orthop 35:1855–1861CrossRef
13.
Zurück zum Zitat D’Arrigo C, Carcangiu A, Perugia D, Scapellato S, Alonzo R, Frontini S et al (2012) Intertrochanteric fractures: comparison between two different locking nails. Int Orthop 36:2545–2551CrossRef D’Arrigo C, Carcangiu A, Perugia D, Scapellato S, Alonzo R, Frontini S et al (2012) Intertrochanteric fractures: comparison between two different locking nails. Int Orthop 36:2545–2551CrossRef
14.
Zurück zum Zitat Yu W, Zhang X, Zhu X, Hu J, Liu Y (2016) A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly. J Orthop Surg Res 11(1):10CrossRef Yu W, Zhang X, Zhu X, Hu J, Liu Y (2016) A retrospective analysis of the InterTan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly. J Orthop Surg Res 11(1):10CrossRef
15.
Zurück zum Zitat Lenich A, Vester H, Nerlich M, Mayr E, Stöckle U, Füchtmeier B (2010) Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip—blade vs screw. Injury 41(12):1292–1296CrossRef Lenich A, Vester H, Nerlich M, Mayr E, Stöckle U, Füchtmeier B (2010) Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip—blade vs screw. Injury 41(12):1292–1296CrossRef
16.
Zurück zum Zitat Vaquero J, Munoz J, Prat S, Ramirez C, Aguado HJ, Moreno E et al (2012) Proximal femoral nail antirotation versus gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study. Injury 43(2):47–54CrossRef Vaquero J, Munoz J, Prat S, Ramirez C, Aguado HJ, Moreno E et al (2012) Proximal femoral nail antirotation versus gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study. Injury 43(2):47–54CrossRef
17.
Zurück zum Zitat Zhang S, Zhang K, Jia Y, Yu B, Feng W (2013) InterTan nail versus proximal femoral nail antirotation-Asia in the treatment of unstable trochanteric fractures. Orthopedics 36(3):288–294CrossRef Zhang S, Zhang K, Jia Y, Yu B, Feng W (2013) InterTan nail versus proximal femoral nail antirotation-Asia in the treatment of unstable trochanteric fractures. Orthopedics 36(3):288–294CrossRef
18.
Zurück zum Zitat Ertürer RE, Sönmez MM, Sarı S, Seckin MF, Kara A, Oztürk I (2012) Intramedullary osteosynthesis of instable intertrochanteric femur fractures with Profin® nail in elderly patients. Acta Orthop Traumatol Turc 46(2):107–112CrossRef Ertürer RE, Sönmez MM, Sarı S, Seckin MF, Kara A, Oztürk I (2012) Intramedullary osteosynthesis of instable intertrochanteric femur fractures with Profin® nail in elderly patients. Acta Orthop Traumatol Turc 46(2):107–112CrossRef
19.
Zurück zum Zitat Huang Y, Zhang C, Luo Y (2013) A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures. Int Orthop 37:2465–2473CrossRef Huang Y, Zhang C, Luo Y (2013) A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures. Int Orthop 37:2465–2473CrossRef
20.
Zurück zum Zitat Nüchtern JV, Ruecker AH, Sellenschloch K, Rupprecht M, Püschel K, Rueger JM et al (2014) Malpositioning of the lag screws by 1- or 2-screw nailing systems for pertrochanteric femoral fractures: mechanical comparison of gamma 3 and intertan. J Orthop Trauma 28:276–282CrossRef Nüchtern JV, Ruecker AH, Sellenschloch K, Rupprecht M, Püschel K, Rueger JM et al (2014) Malpositioning of the lag screws by 1- or 2-screw nailing systems for pertrochanteric femoral fractures: mechanical comparison of gamma 3 and intertan. J Orthop Trauma 28:276–282CrossRef
21.
Zurück zum Zitat Gardenbroek TJ, Segers MJ, Simmermacher RK, Hammacher ER (2011) The proximal femur nail antirotation: an identifiable improvement in the treatment of unstable pertrochanteric fractures? J Trauma 71(1):169–174CrossRef Gardenbroek TJ, Segers MJ, Simmermacher RK, Hammacher ER (2011) The proximal femur nail antirotation: an identifiable improvement in the treatment of unstable pertrochanteric fractures? J Trauma 71(1):169–174CrossRef
22.
Zurück zum Zitat Yaozeng X, Dechun G, Huilin Y, Guanming Z, Xianbin W (2010) Comparative study of trochanteric fracture treated with proximal femoral nail anti-rotation and the third generation of gamma nail. Injury 41:1234–1238CrossRef Yaozeng X, Dechun G, Huilin Y, Guanming Z, Xianbin W (2010) Comparative study of trochanteric fracture treated with proximal femoral nail anti-rotation and the third generation of gamma nail. Injury 41:1234–1238CrossRef
Metadaten
Titel
The impact of proximal femoral nail type on clinical and radiological outcomes in the treatment of intertrochanteric femur fractures: a comparative study
verfasst von
Altuğ Duramaz
Mehmet Hakan İlter
Publikationsdatum
30.05.2019
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 7/2019
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-019-02454-y

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