Objective to evaluate longterm radiographic and functional outcomes between dynamic hip screw dhs and proximal femoral nail antirotation pfna fixation. Pfnaii presentation free download as powerpoint presentation. Large surface and increasing core diameter guarantee maximum compaction and optimal hold in bone increased stability caused by bone compaction around the. It is easily inserted with few intra and postoperative complications and allows early weight bearing on the affected limb as well as quicker rehabilitation of patients. As we are continuously developing our products, hence the products supplied may be more advanced in details with the description or illustrations shown in our website or catalogs. From 15 months postoperatively to the final followup, the hhs was consistently greater in the it than pfnaii group table 3. The pfna augmented proximal femoral nail antirotation, synthes inc. The proximal femoral nail antirotation pfna was first designed in 2004 by ao synthes, and pfnaii asian version was introduced in 2008. The cause of postoperative failure after the treatment of femoral intertrochanteric fracture with proximal femoral nail antirotation pfna was analyzed, and the reoperative methods were examined. The purpose of the present study was to evaluate the outcomes of the asian proximal femur intramedullary nail antirotation system pfnaii for stabilization of such fractures. Nov 30, 2019 the proximal femoral nail antirotation pfna was first designed in 2004 by ao synthes, and pfnaii asian version was introduced in 2008.
The purpose of this study was to compare the biomechanical strength of the cephalomedullary nail intertan in cases of intertrochanteric fractures with the commonly used pfna. Proximal femoral nail antirotation pfna versus gamma. Tfnadvanced proximal femoral nailing system tfna the tfnadvanced proximal femoral nailing system tfna is designed to advance hip fracture treatment with. Treatment of unstable intertrochanteric fractureswith. Aug 18, 2008 proximal femoral nail antirotation pfna versus gamma nail 3 gamma3 for intramedullary nailing of unstable trochanteric fractures progaintes the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The pfnaii was used to treat intertrochanteric fractures in 163 elderly patients from march 2010 to march 20. To achieve rotational and angular stability, in 2004, the proximal femoral nail antirotation pfna device, one of the thirdgeneration intramedullary implants pfna.
Pfna depuy synthes pdf catalogs technical documentation. Comparative study on proximal femur locking plate and. Comparison of proximal femoral nail antirotation pfna with. Do pfna devices and intertan nails both have the same effects in the treatment of trochanteric fractures. The pfna is an excellent implant for stabilisation of both trochanteric and complex combination fractures as well as an exceptional device for reosteosynthesis. Jcm free fulltext functional and radiological results. Review of proximal nail antirotation pfna malaysian. A number of different implant options are available for the management of this injury. Proximal femoral nail pfna nail the anatomical design guarantees an optimal fit in the femur. Intertan nail versus proximal femoral nail antirotationasia. Proximal femoral nail antirotation pfna was theoretically designed to be an ideal intramedullary device for the fixation of intertrochanteric fractures by providing angular and rotational stability. To compare the longterm functional and radiographic outcomes of the proximal femoral nail antirotationasia pfna ii and intertan nail it in the management of intertrochanteric femoral fractures iffs aoota type 3iai.
The pfna ii was used to treat intertrochanteric fractures in 163 elderly patients from march 2010 to march 20. The sizes of pfna ii nail used are depicted in table 1. Department of orthopaedics, the second hospital of anhui medical university, 678, furong avenue, hefei, anhui 230601, pr china a r t i c l e i n f o article history. Comparison of the curative effects of pfna and dhs. The aim in this study was to compare the curative effects of proximal femoral nail antirotation pfna and cementless bipolar hemiarthroplasty cph on femoral intertrochanteric fracture in the elderly. Modern implants for proximal femur fracture treatment have. Pdf the pfna proximal femur nail in treatment of unstable.
Comparison of the curative effects of pfna and dhs fixation. Pfna with and without cement augmentation sage journals. The law curve of the hhs changes is shown in figure 2. Complete traumatic backout of the blade of proximal femoral. Computerassisted preoperative planning improves the. The objective of this study was to compare the clinical results and complications of proximal femoral nail antirotation pfna on treatment of intertrochanteric fractures in 120 elderly chinese patients using randomized controlled trials rcts. The preferred treatment of intertrochanteric fractures in aged patients is controversial. The pfna proximal femur nail in treatment of unstable. We compared nail positioning, major and minor complication rates, operative and fluoroscopy time, blood transfused, time to. Received 5 may 2014 accepted 17 december 2014 keywords.
The asia proximal femoral nail antirotation versus the. Review of proximal nail antirotation pfna and pfna2 our local experience wl loo, m med orth, syj loh, frcs edin, hc lee, frcs edin department of orthopaedic surgery, changi general hospital, singapore corresponding author. Pfna interlocking nail new gam interlocking nailshort. Original article is proximal femoral nail antirotation. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. Send orders for reprints to email protected 232 the open orthopaedics journal, 2014, 8, 232236 open access the pfna augmented in revision surgery of proximal femur fractures alexander scola, florian gebhard, christoph dehner and gotz roderer ulm university, department of orthopaedic trauma, ulm, germany abstract. Our case series performed standard pfna fixation without cement augmentation between 2015 until 2017 for intertrochanteric fracture in elderly patients n84. Recent studies showed that proximal femoral nail antirotation pfna with cement augmentation might be useful for postoperative functional.
An unusual case of late central protrusion of the helical blade of. Review of proximal nail antirotation pfna and pfna2our. Proximal femoral nail antirotation pfna is an intramedullary device that is advantageous because of its helical blade. The purpose of the present study was to evaluate the outcomes of the asian proximal femur intramedullary nail antirotation system pfna ii for stabilization of such fractures. Comparison of the biomechanical effects of pertrochanteric fixator and dynamic hip screw on an intertrochanteric femoral fracture using the finite element method. To compare and analyse retrospectively the clinical effect of proximal femoral nail anti rotation ii pfnaii and proximal femur locking plate pflp for the treatment of intertrochanteric fracture in the elderly. A comparative biomechanical study of proximal femoral nail. In our experience, proximal femoral nail antirotation pfna is an excellent device for osteosynthesis as it can be easily inserted, it provides angular and rotational stability and allows early weight bearing on the affected limb. Both nails have a tendency to provide rotational and angular stability. Shortterm followup results from previous studies 1 3 have shown that the intertan nail it smithnephew, memphis, tn is superior to the proximal femoral nail antirotationasia pfnaii synthes, solothurn, switzerland for treatment of intertrochanteric femoral fractures iffs in patients with osteoporosis. Pdf do pfna devices and intertan nails both have the same. From march 2008 to december 2012, 108 elderly patients with femoral.
Between march 20 and december 2015, fifty patients 28 male and 22 females with a mean age of 72. Apr 17, 2017 a total of 161 elderly patients with intertrochanteric fracture, who underwent either pfna or pflp in our hospital from march 2012 to march 20, were enrolled in the study. Twodevice procedures were suggested because of the higher rate of malunion by singledevice treatment. Intertan nail versus proximal femoral nail antirotation. This study was proposed to determine the optimal greater trochanteric entry point for. Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. Proximal femoral nail antirotation asian version pfnaii is widely used for intertrochanteric fracture treatment. Synthes oberdorf, switzerland, was developed by the aoasif group.
We investigated when compared with gamma nail gn and dynamic hip screw dhs whether pfna was associated with 1 a lower. Pfna blade bone structure after pfna blade insertion cancellous bone is compacted providing additional anchoring to the pfna blade. Clinical evaluation of the asian proximal femur intramedullary nail. We evaluated radiographic and functional outcomes of patients with unstable pertrochanteric fractures treated with the proximal femur nail antirotation pfna.
Oct 29, 2019 the treatment for unstable intertrochanteric fractures in the elderly has always been a controversial issue. Pertrochanteric femur fractures are considered amongst the most commonly encountered fractures in the geriatric age group. The purpose of the present study was to evaluate the outcomes of the asian proximal femur. The computerassisted preoperative planning capp system has the potential to reduce the difficulty of pfna ii in the treatment of intertrochanteric fractures. The proximal femoral nail antirotation device pfna is a typical implant to the treatment of intertrochanteric fractures. Pfna blades have been biomechanically proven to compact cancellous bone and achieve increased stability and. Proximal femoral nail antirotation asian version pfna ii is widely used for intertrochanteric fracture treatment. Proximal femoral nail antirotation versus cementless bipolar. Clinical evaluation of the asian proximal femur intramedullary nail antirotation system pfnaii for. The pfna proximal femur nail in treatment of unstable proximal femur fractures3 cases of postoperative perforation of the helical blade into the hip joint j orthop trauma 2008. Reason and treatment of failure of proximal femoral nail. Han a comparative study of proximal femoral locking compress plate, proximal femoral nail antirotation and dynamic hip screw in intertrochanteric fractures.
The pfna nail for pertrochanteric fracture of the femur without fracture table article pdf available january 2011 with 81 reads how we measure reads. Commonly used nail diameter was 10 mm, which was used in 33 patients. View and download synthes tfn technique manual online. Pdf the proximal femoral nail antirotation pfna device was recently. Proximal femoral nail antirotation pfna versus gamma nail. Pccp versus proximal femoral nail antirotation pfna in the treatment of intertrochanteric fractures in elderly patients. Complete traumatic backout of the blade of proximal. The proximal femoral nail antirotation pfna device was recently introduced as an option for intramedullary management of pertrochanteric hip fractures. Proximal femoral nail antirotation versus gamma3 nail for. Pfnaii proximal femoral nail antirotation introduction the pfna system was introduced by ao in 2003 for treating unstable trochanteric fractures. Pdf do pfna devices and intertan nails both have the.
Clinical outcomes of pfnaii in the asian intertrochanteric. Proximal femoral nail antirotation pfna is an intramedullary device designed with a helical blade rather than a screw, and is expected to provide better angular and rotational stability, and reduce the implantrelated complications 6, 7. Randomized controlled trials of proximal femoral nail. The pfna augmented in revision surgery of proximal femur. Poinformatie en complicaties werden geregistreerd, en beoordelingen van het functioneel resultaat werden gemaakt. We compared nail positioning, major and minor complication rates, operative and fluoroscopy time, blood transfused, time to mobilization, hospital stay, fracture union, and harris hip score. Dynamic hip screw dhs and gamma nail were commonly used but often associated. A 94yearold woman sustained an intertrochanteric fracture of the left femur. The proximal femoral nail antirotation pfna in the. However, refracture of the femur shaft after nailing are usually been reported. Conventional intramedullary nails including gamma 3 locking nail and proximal femoral nail antirotation pfna were designed for unstable intertrochanteric fractures. Biomechanical effect of bone cement augmentation on rotational stability and pullout strength of the proximal femur nail.
Comparison of clinical outcomes with intertan vs gamma nail. In 2003, the proximal femoral nail antirotation pfna system was put into clinical use by the association for. Proximal femoral nail antirotation2 pfna2 has been widely used to treat intertrochanteric fractures with varied outcomes in the previous studies. Proximal femoral nail antirotation technique guide synthes 3. However, surgical treatment using a cephalomedullary nail is still an alternative option that provides better.
Background the preferred treatment of intertrochanteric fractures in aged patients is controversial. Loo wee lim, department of orthopaedic surgery, changi general hospital, 2 simei street 3, singapore 529889. The results of unstable intertrochanteric femur fracture. Proximal femoral nail antirotation versus cementless. Pdf the pfna nail for pertrochanteric fracture of the. Functional and radiological results of proximal femoral nail. A total of 161 elderly patients with intertrochanteric fracture, who underwent either pfna or pflp in our hospital from march 2012 to march 20, were. The entry point of the nail plays an important role in achieving acceptable reduction, stable fixation, and avoiding implant related complications.
More than five years in the making, this system offers advancement in hip. Mechanical failures after fixation with proximal femoral nail and risk factors mechanical failures. Between february 2007 and august 2009, 76 patients underwent the pfna fixation for proximal femoral fractures 15. Sep 29, 2015 pfna nail surgical technique animation created by kems studio. Comparison of proximal femoral nail antirotation pfna. Furthermore, the results ofthe primary treatment of osteoporotic proximal femur fractures are promising. Listing a study does not mean it has been evaluated by the u. Comparison of clinical outcomes with intertan vs gamma. Computerassisted preoperative planning improves the learning.
Pfna nail product range the pfna is available in 4 sizes pfna long, length 300 420 mm, with 20 mm increments, bending radius 1500 mm pfna, length 240 mm pfna small, length 200 mm pfna xs, length 170 mm pfna. However, refracture of the femur shaft after nailing are usually been rep. A comparison of proximal femoral nail antirotation and. Nov, 2014 the preferred treatment of intertrochanteric fractures in aged patients is controversial. 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. Ipsilateral femoral neck and shaft fractures fixation with. Most commonly used nail size was the smaller version 200 mm length and commonly used blades were between 90105 mm. Proximal femoral nail antirotation versus dynamic hip screw fixation. Mechanical failures after fixation with proximal femoral. Pdf the pfna nail for pertrochanteric fracture of the femur.
Nov 21, 2017 conventional intramedullary nails including gamma 3 locking nail and proximal femoral nail antirotation pfna were designed for unstable intertrochanteric fractures. Nine failures of 308 femoral intertrochanteric fracture patients with pfna were treated with femoral prosthesis total hip replacement thr and reoperative internal fixation. Proximal femoral nails antirotation, gamma nails, and dynamic hip. Totaly 120 cases enrolled were randomly assigned to a lateral decubitus position group and supine position group. A retrospective analysis of the intertan nail and proximal femoral nail antirotationasia in the treatment of unstable intertrochanteric femur fractures in the elderly. Meanwhile, proximal femoral nail anti rotation pfna fixation has recently been. Proximal femoral nail antirotation pfna versus gamma nail 3 gamma3 for intramedullary nailing of unstable trochanteric fractures progaintes the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Percutaneous compression plate versus proximal femoral nail anti. Sixteen fresh specimens of the proximal femur were used as intertrochanteric fracture models and were fixed using two fixation devices. The computerassisted preoperative planning capp system has the potential to reduce the difficulty of pfnaii in the treatment of intertrochanteric fractures. However, it was designed according to the geometric proportions of the white population, and it is known that important differences exist between asians and americans with regard to femoral geometry. As we know, intramedullary nail was appropriately applied for unstable intertrochanteric fracture 11,12, however, failure rate requiring reoperation was reported up to 5. The tfna system is designed to solve a wide range of unmet needs for surgeons, or staff, and administrators. The new proximal femoral nail antirotation pfna in daily practice. Both implants have standard neckshaft angles of 125 or and were inserted using percutaneous technique and reaming in the majority of the cases 70% fig. The pfna nail group consisted of 8 men and 5 women mean age, 53 years. There were 82 patients in pfna group, 27 male, 55 female, mean age 79. Intertrochanteric femoral fractures are prevalent among the elderly, and usually demands surgical treatments. The standard implant for pfna was a nail of 200 mm in length and 11 mm in diameter whereas the gamma3 used was a 180 mm nail of 11 mm diameter. Pfna nail surgical technique animation created by kems studio.
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