Cephalic intramedullary nails with proximal antirotation device are the treatment of choice for such patients. Combining a hip pin which provides rotational stability with a loadbearing femoral neck screw ensures intra and postoperative safety. Carbofix piccolo proximal nail is fda cleared and ce marked. Randomized controlled trials of proximal femoral nail.
The nail had proximal 6 mediolateral angle for smooth fit in the trochanter. The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus. Proximal femoral nail antirotation in treatment of fractures of proximal femur med arh. Bipolar hip prosthesis, fenestrated stem, sterile, ss. Synthes, solothurn, switzerland system for intertrochanteric femoral fractures15.
Comparative study of the proximal femoral nail antirotation. Splitting of the proximal femur with a new femoral nail maj joseph r. This biomechanical study was conducted to compare fixation stability of the proximal fragments and their mechanical characteristics in proximal femur models of unstable basicervical it fractures fixed by cephalomedullary nailing using 3 different types of the femoral head fixation. Position the carm for an ap view of the proximal femur. Use of a reconstruction nail or trochanteric nail for the treatment of complex proximal femoral fractures is the favorable method, 7,8 but associated complications, including iatrogenic femoral. Proximal femoral nail antirotation in treatment of fractures of proximal femur 174 med arh. Totaly 120 cases enrolled were randomly assigned to a lateral decubitus position group and supine position group.
The only intervention was intertan nail or pfnaii fixation of the unstable. The top countries of suppliers are india, china, and india, from which the percentage of proximal femur nail supply is 36%, 56%, and 36% respectively. Reason and treatment of failure of proximal femoral nail. Biomechanical effect of bone cement augmentation on rotational stability and pullout strength of the proximal femur nail. Synthes, paoli, pennsylvania with a reconstruction nail recon. S erhart, w schmoelz, m blauth, a lenichbiomechanical effect of bone cement augmentation on rotational stability and pullout strength of the proximal femur nail antirotation injury, 42 11 2011, pp. The incidence of this disorder has increased markedly in recent years owing to continuously aging populations bonnaire et al. Ufn unreamed femoral nail cfn cannulated femoral nail. Unreamed insertion possible nail diameters of 10, 11 and 12 mm permit insertion without reaming allowing a simpli. The full text of this article is available in pdf format. Jun 07, 2018 new system is designed to enhance anatomic fit and offer surgeons more options to improve patient outcomes. To be included in the study patients must have had a synthes titanium elastic nail synthes corp. It has been estimated that intertrochanteric fractures occur in more than 200,000 people each year in the united states, with reported mortality rates ranging from 15% to 30% there is a considerable debate regarding which is the optimal implant for fixing intertrochanteric fractures. Tfnadvanced proximal femoral nailing system tfna the tfnadvanced proximal femoral nailing system tfna is designed to advance hip fracture treatment with.
Feb 04, 2017 nail insertion and standard proximal locking implant removal recon locking presenters. Original instruments and implants of the association for the study of internal fixation aoasif. Proximal femoral nail antirotation introduction intertrochanteric femoral fractures are common among elderly patients. Unstable trochanteric fractures have been an enigma for the orthopedic surgeon in the community because of unpredictable results. Although it is known pfna system provides high union rates with low major complication rates, geometric discrepancies exist between the proximal femur and pfna system. Results we identified 19 patients who had retrograde flexible intramedullary nailing of their femur fractures during a 5. Strength and stability in the proximal femur optimal lag screw design for resistance to cutout easytouse instrumentation and targeting jig, which includes goal post technology, aids in lag screw placement extensive range of neckshaft angles, distal diameters, and nail lengths combined with a small proximal nail.
Pfna depuy synthes pdf catalogs technical documentation. Comparative study of the proximal femoral nail antirotation versus the reconstruction nail in the treatment of comminuted proximal femoral fracture. Examples include the gamma nail strykerhowmedica, the intramedullary hip screw smith and nephew richards, the proximal femoral nail synthes and the ace trochanteric nail depuy orthopaedics. Proximal femoral nail antirotation pfnatm fixation of extra. The proximal screw inclination angle was of and 5 and the proximal screw had an anteversion angle of 10.
Risks associated with magnetic resonance imaging mri of patients with hip and knee. Mar 01, 20 cutout rates, including the z effect, have been reported to range from 3% to 10% 7,9,2124 with the gamma nail, proximal femoral nail, and dynamic hip screw but are lower with the pfna 1%3%. Proximal femur targon pft the new targon pft nailing system is designed to treat all trochanteric fractures in a fast and safe procedure. Although biomechanical studies have shown pflps to be stronger or equivalent to other. Proximal femoral nails antirotation, gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur.
Ipsilateral proximal femur, tibia or ankle open injuries occur in 510% early administration of antibiotics with a thorough debridement and irrigation is of utmost importance transfer to definitive tertiary care center temporizing with external fixation may be necessary. Proximal femoral nail antirotation pfnatm fixation of. Proximal femoral nails that we used had the proximal diameter of 15 mm and length varied from 38 to 42 cm. The pfna augmented in revision surgery of proximal femur. Paulo barbosa, clifford turen this video is for research purpose only. Distal femur fractures orthopaedic trauma association ota. Proximal femoral nail pfn specification rotational stability. The nail cap is made of composite material and is radiolucent. A 30yearold woman with a comminuted proximal femoral fracture a. Pfn proximal femoral nail royal childrens hospital.
Proximal femoral nail antirotation surgical technique depuy synthes 11 2 confirm nail length and diameter instrument 309. Consult depuy synthess entire expert tibia nail catalogue on medicalexpo. The pfnaii was used to treat intertrochanteric fractures in 163 elderly patients from march 2010 to march 20. Long proximal femoral nail in ipsilateral fractures.
Treatment of the proximal femoral fractures with proximal femoral nail antirotation pfna. Fixation with the pfna nail synthes, paoli, pennsylvania b and bone union 3 months later c. Expert tibial nail comprehensive solutions versatile proximal locking. Pfna, designed by ao in 2004, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head 2, 3. Brown, md and the skeletal trauma research consortium strec summary. Carry the dissection down to the gluteus medius fascia longitudinally in the direction of the wound. Proximal femoral nail pfna nail the anatomical design guarantees an optimal fit in the femur. With a growing aging population, the incidence of intertrochanteric fractures is rising. 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.
Jan 01, 2012 use of a reconstruction nail or trochanteric nail for the treatment of complex proximal femoral fractures is the favorable method, 7,8 but associated complications, including iatrogenic femoral. This investigation was prompted by a series of cases of observed breakage of the recently introduced tfna proximal femoral nailing system tfn trochanteric fixation nail advanced. Intertrochanteric hip fracture, pfna fixation, extracapsular fracture, proximal femoral helical. New system is designed to enhance anatomic fit and offer surgeons more options to improve patient outcomes. 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. Proximal femoral nail antirotation in treatment of fractures. The purpose of our study was to compare the proximal femoral nail antirotation pfna. Table 2 from comparative study of the proximal femoral. Predictors of failure following fixation of intertrochanteric. Nov 19, 2016 bipolar hip prosthesis, fenestrated stem, sterile, ss. Finite element analysis of proximal femur nail for. Unstable proximal femur fractures treated with proximal. Cutout rates, including the z effect, have been reported to range from 3% to 10% 7,9,2124 with the gamma nail, proximal femoral nail, and dynamic hip screw but are lower with the pfna 1%3%. Proximal femoral nails antirotation, gamma nails, and dynamic.
More than five years in the making, this system offers advancement in hip. Mechanical failure of intramedullary nails is rare. May 31, 2014 examples include the gamma nail strykerhowmedica, the intramedullary hip screw smith and nephew richards, the proximal femoral nail synthes and the ace trochanteric nail depuy orthopaedics. Intertan nail versus proximal femoral nail antirotationasia. Gamma3 long nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10cm proximal to the intracondylar notch including fractures of the basilar neck, intertrochanteric fractures, peritrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. Depuy synthes launches innovative nailing system aimed at. As part of the depuy synthes portfolio, the frn leverages the global success and learnings of the expert nail system and the tfnadvanced proximal femur nailing system tfna the frn system provides the choice of piriformis fossa pf and greater trochanter gt entry. Pdf treatment of the proximal femoral fractures with. Check the reduction and read off the required nail length on the ruler as it appears in the xray. The pfna proximal femur nail in treatment of unstable proximal femur fractures3 cases of postoperative perforation of the helical blade into the hip joint. Long proximal femoral nail in ipsilateral fractures proximal. To estimate the nail diameter, place the template on the lateral xray of the uninjured femur and measure the dia. Radiopaque markers around the drill holes and along the nails length. Some unique characteristics of the pfna nail include the nail curvature which better matches the anatomy of the femur, the material a composite of titanium resulting in a.
The pfnaii was used to treat intertrochanteric fractures in 163 elderly patients from. Synthes long proximal femoral nails pfn, pfnapfnaii and. The implant proximal femur nail pfn was selected for evaluation and comparison with the intact femur. Intertrochanteric femur fractures are one of the most serious causes of mortality and morbidity in the elderly. The tfna system is designed to solve a wide range of unmet needs for surgeons, or staff, and administrators. To simplify the experimental crossvalidation of numerical studies, a cad solid model of a synthetic human femur standardized femur, commonly used in experiments in vitro, was made. To report outcomes of 36 consecutive patients treated with a proximal femoral nail pfna for osteoporotic trochanteric. Nov, 2014 the preferred treatment of intertrochanteric fractures in aged patients is controversial. The innovative targeting device is suitable for all ccd angles and permits shorter and less invasive incisions thanks to an optimized geometry. A wide variety of proximal femur nail options are available to you, there are 1 suppliers who sells proximal femur nail on, mainly located in asia. Protect the proximal nail thread against tissue ingrowth extensions of 10 and 20 mm. Implant fracture analysis of the tfna proximal femoral nail. The nail design has been well proven in over 200 000 cases performed with the pfn. Zimmer, warsaw, indiana in the treatment of comminuted proximal femoral fractures.
A total of 2 consecutive patients with unstable trochanteric fractures of the femur were enrolled in the study. Proximal femoral nail antirotation versus gamma3 nail for. Proximal femoral nail pfn specification, uses, sizes. Proximal femoral nails antirotation, gamma nails, and. Proximal femoral nail antirotation in treatment of. Femur shaft fracture intramedullary nailing with the. Adolescent lateral entry femoral nail surgical technique guide. Figure 1 from comparative study of the proximal femoral. Surgical treatment of basicervical intertrochanteric. A mature system insertion of the nail proximal locking with hip pin and. Proximal femoral nail pfn specification, uses, sizes vast.
Furthermore, the results ofthe primary treatment of osteoporotic proximal femur fractures are promising. Furthermore, the development of the t2 femoral nailing system offers the competitive advantages of. Proximal femoral locking compression plate for proximal. Intertan nail versus proximal femoral nail antirotation. We present a case of a 19yearold woman with a closed diaphyseal femur fracture and who had. Femur shaft fracture intramedullary nailing with the expert. The femoral recon nail frn system is an integrated nailing system designed to adapt to multiple surgical approaches. Expert lateral femoral nail surgical technique depuy synthes 1. The preferred treatment of intertrochanteric fractures in aged patients is controversial.
Splitting of the proximal femur with a new femoral nail. Examples of specific indications according to ao classification include type afractures, dislo. The t2 proximal humeral nail is intended for single use only. As part of the depuy synthes portfolio, the frn leverages the global success and learnings of the expert nail system and the tfnadvanced proximal femur nailing system tfna. For full information on indications, contraindications, warnings and precautions please see the product specific ifu and surgical. The pfna augmented proximal femoral nail antirotation, synthes inc. Expert tibia nail depuy synthes pdf catalogs technical. Nail insertion and standard proximal locking implant removal recon locking presenters. Proximal femoral nail antirotation surgical technique depuy synthes. Radiographic outcomes of osteosynthesis using proximal. Techniquenail insertion for pediatric femur opening the femur creating the nail entry point make an incision on the lateral or medial aspect of the distal femur, starting 3 cm above the physis and extending distally for 2. Figure 1 from comparative study of the proximal femoral nail.
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