Mechanical complications of intertrochanteric hip fractures treated with trochanteric femoral nails

被引:81
作者
Liu, Wanjun [1 ]
Zhou, Dongsheng [2 ]
Liu, Fang [3 ]
Weaver, Michael J. [4 ]
Vrahas, Mark S.
机构
[1] Shanghai Sixth Peoples Hosp, Dept Orthopaed, Shanghai, Peoples R China
[2] Shandong Univ, Affiliated Shandong Prov Hosp, Dept Orthopaed, Jinan 250100, Peoples R China
[3] Massachusetts Gen Hosp, Dept Orthopaed Srug, Bioengn Lab, Boston, MA 02114 USA
[4] Brigham & Womens Hosp, Boston, MA 02115 USA
关键词
Intertrochanteric hip fracture; trochanteric fixation nail; fracture fixation; cephalomedullary nail; complications; GAMMA-NAIL; INTRAMEDULLARY NAIL; FIXATION NAIL; SCREW; FAILURE; PLATE; PFN;
D O I
10.1097/TA.0b013e31829a2c43
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BACKGROUND: The Trochanteric Fixation Nail System (TFN) was designed with a helical blade to improve resistance to cutout. We evaluated the incidence, modes, and predictors of failure for intertrochanteric hip fractures treated with this device. METHODS: A retrospective review of 341 intertrochanteric hip fractures treated with the TFN was conducted. Fractures were classified from the injury films using the Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classification, and quality of reduction and hardware placement was evaluated on the initial postoperative films. RESULTS: Two hundred twenty-three patients met inclusion criteria. The overall rate of mechanical complications was 20.5%. Twenty-one patients (9.4%) had excessive lateral migration of the helical blade (>= 10 mm). Fifteen patients (6.7%) had blade migration in the head, including 7 patients (3.1%) with typical cutout and 8 patients (3.6%) with medial perforation without loss of reduction. Three patients (1.3%) sustained a femoral shaft fracture at the tip of the nail. The quality of calcar reduction was significantly predictive of all modes of failure (p < 0.05), except femoral shaft fracture at the nail tip. CONCLUSION: The most common mechanical complication was lateral migration of the helical blade; however, this rarely led to a clinical problem. Medial migration of the blade in the head without loss of reduction was the second most frequent complication. We have identified a new complication associated with the TFN, that is, medial perforation without loss of reduction. Blade migration in the head was less frequent when blades were placed inferiorly with a tip-apex distance of at least 15 mm. (Copyright (C) 2013 by Lippincott Williams & Wilkins)
引用
收藏
页码:304 / 310
页数:7
相关论文
共 50 条
  • [41] Trochanteric Entry for Femoral Lengthening Nails in Children: Is It Safe?
    Hammouda, Ahmed I.
    Jauregui, Julio J.
    Gesheff, Martin G.
    Standard, Shawn C.
    Herzenberg, John E.
    JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2017, 37 (04) : 258 - 264
  • [42] Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases
    Korkmaz, Mehmet Fatih
    Erdem, Mehmet Nuri
    Disli, Zeliha
    Selcuk, Engin Burak
    Karakaplan, Mustafa
    Gogus, Abdullah
    CLINICAL INTERVENTIONS IN AGING, 2014, 9 : 569 - 574
  • [43] Treatment of reverse oblique trochanteric femoral fractures with proximal femoral nail
    Ozkan, Korhan
    Eceviz, Engin
    Unay, Koray
    Tasyikan, Levent
    Akman, Budak
    Eren, Abdullah
    INTERNATIONAL ORTHOPAEDICS, 2011, 35 (04) : 595 - 598
  • [44] Trochanteric Nails for the Reduction of Intertrochanteric Fractures: A Biomechanical Analysis Based on Finite Element Analysis and DIC System
    Tsai, Ming-Tzu
    Lee, Cheng-Hung
    Chen, Kun-Hui
    Yen, Yu-Chun
    Wang, Chun-Hsiang
    Wang, Shun-Ping
    Su, Kuo-Chih
    JOURNAL OF MEDICAL AND BIOLOGICAL ENGINEERING, 2022, 42 (04) : 459 - 468
  • [45] Biomechanical analysis of the cephalomedullary nail versus the trochanteric stabilizing plate for unstable intertrochanteric femur fractures
    Walmsley, David
    Nicayenzi, Bruce
    Kuzyk, Paul R. T.
    Machin, Alan
    Bougherara, Habiba
    Schemitsch, Emil H.
    Zdero, Radovan
    PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, 2016, 230 (12) : 1133 - 1140
  • [46] Short Versus Long Cephalomedullary Nails for Pertrochanteric Hip Fractures: A Randomized Prospective Study
    Shannon, Steven F.
    Yuan, Brandon J.
    Cross, William W., III
    Barlow, Jonathan D.
    Torchia, Michael E.
    Holte, Pamela K.
    Sems, Stephen A.
    JOURNAL OF ORTHOPAEDIC TRAUMA, 2019, 33 (10) : 480 - 486
  • [47] Cementation of proximal femoral nails of the very elderly subject in per-trochanteric fractures
    Plang, Sorya
    Dayan, Romain
    Khiami, Frederic
    Preneau, Clement
    Barbier, Olivier
    Choufani, Camille
    ACTA ORTHOPAEDICA BELGICA, 2021, 87 (02): : 293 - 298
  • [48] Rehabilitation protocols in unstable trochanteric fractures treated with cephalomedullary nails in elderly: current practices and outcome
    Lizano-Diez, Xavier
    Keel, Marius Johann Baptist
    Siebenrock, Klaus Arno
    Tey, Marc
    Bastian, Johannes Dominik
    EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, 2020, 46 (06) : 1267 - 1280
  • [49] Intramedullary nails for extracapsular hip fractures in adults
    Queally, Joseph M.
    Harris, Ella
    Handoll, Helen H. G.
    Parker, Martyn J.
    COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (09):
  • [50] A Comparison of Proximal Femoral Nail Antirotation and Dynamic Hip Screw Devices in Trochanteric Fractures
    Zou, J.
    Xu, Y.
    Yang, H.
    JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, 2009, 37 (04) : 1057 - 1064