Randomized controlled trials of proximal femoral nail. Position the carm for an ap view of the proximal femur. Patients in the pfna group were applied proximal femoral intramedul lary nail fixation, whereas those in the ha group received ha. The neck shaft angle of 5 degrees was used in the forty eight patients whereas the rest needed a degree nail. Please check the sterility of each device on the product label. Orthofix supplies the centronail titanium universal femoral nail, locking screws and end caps in a sterile package, while the instruments are supplied nonsterile. Trigen im nail system femoral tibial intertan short and long lengths metanail retrograde femoral fan femoral antegrade nail standard and recon locking options tan metanail tibial trochanteric antegrade nail standard and recon locking options. We aimed to evaluate and compare the clinical and functional outcomes of dynamic hip screw dhs and proximal femoral nail antirotation pfna treatment of ao type 1 intertrochanteric fractures in elderly patients. Intramedullary nail system for proximal femoral fractures. Lengthening of the femur with a remotecontrolled magnetic. Phoenix antegrade femoral nail system featuring corelock. Pfn proximal femoral nail royal childrens hospital. The following surgical technique describe the surgical procedure which is recommended by the authors.
Intramedullary nailing of femoral shaft fractures has been accepted as a standard technique. Pdf the proximal femoral nail pfn a minimal invasive. Cai 1department of orthopedic surgery, shanghai tenth peoples hospital, tongji university, school of medicine, shanghai, china. Tfnadvanced proximal femoral nail system tfna value. Short proximal nail end designed to reduce the risk of nail prominence compared with nails with a longer nail end. The broken intramedullary part of the system could be removed in all cases. Complex proximal femoral fractures in the elderly managed by. The proximal femoral nail of 250 mm used in this study was made of 316l stainless steel and the diameters used were 9 mm, 10 mm and 11 mm. Insert the pfna blade to the stop by applying gentle blows with the hammer. The pedinail intramedullary nail is anatomically designed to meet the unique needs of pediatric and adolescent patients, and is available in diameters of 7, 8, 9, and 10mm with lengths ranging from 2038cm. 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. Browse our proximal femoral nail pfn catalogue online and request a free quote now. Femoral reconstruction with an osteotomy around an existing intramedullary nail was introduced to address axial deformity correction and limb lengthening without changing or removing a previously inserted imn.
The centronail titanium universal femoral nailing system. This case series underscores the necessity of followup distal femur radiographs in patients after long antegrade femoral nail placement. Comparative prospective study of proximal femoral nail and dynamic. Some of the factors found to be associated with a patient sustaining an intertrochanteric rather than a femoral neck fracture include advancing age, increased number of comorbidities. Apr 15, 2004 osteosynthesis with the proximal femoral nail pfn features the advantages of high rotational stability of the headneck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. The pfna blade claims to compact the cancellous bone to provide increased stability and this has been biomechanically proven to retard rotation and varus collapse. Phoenix antegrade femoral nail system featuring corelock technology 20 biomet orthopedics form no. Disclaimer this document is intended exclusively for experts in the field, i.
Comparison of dynamic hip screw and proximal femoral nail antirotation. Pdf proximal femoral nail failures in extracapsular. Determine nail insertion point and insert guide wire in the ap view, the nail insertion point is normally found on the tip or slightly lateral to the tip of the greater trochanter in the curved extension of the medullary cavity. Canal preparation nail selection figure 10 figure 11 surgical technique proximal end color pink darkgolden nail type left right neogen femoral nail. Meanwhile, proximal femoral nail antirotation pfna fixation has recently been developed for minimally invasive surgery to reduce the complications rate. Augmentation of proximal femoral nail in unstable trochanteric fractures wasudeo m. Femoral shaft fractures proximal or midshaft femoral nonunions and malunions pathologic fractures in osteoporotic bone of the diaphyseal area revision procedures retrograde locking option antegrade locking options the universal femoral nail hole configurations provide. We export and supply high quality femoral nails at best price. After confirming compression and rotation of the fragment and nail, proximal fixation screws can be inserted into the proximal screw holes to secure the humeral head fragment. P janardhana aithala, s rao open journal of orthopedics, 20 file. Proximal femoral nail antirotation versus hip arthroplasty for. Lower limb clinical and functional outcomes of treatment. Titanium alloy for improved mechanical and fatigue properties.
Jun 21, 2006 proximal femoral nail an analysis of 100 cases of proximal femoral fractures with an average follow up of 1 year w. Proximal femoral nails antirotation, gamma nails, and dynamic. Proximal femoral nail an analysis of 100 cases of proximal. Pfna nail surgical technique animation created by kems studio.
The aoasif proximal femoral nail antirotation pfna. Proximal femoral nail standard pfn and long pfn 12 1. Standard pfn and long pfn simple, reliable, versatile. The presence of the nail has minimized the time needed for the. Proximal femoral nail antirotation surgical technique depuy synthes 11 2 confirm nail length and diameter instrument 309. Additionally our perfect femoral nail is indicated for fractures in the subtrochanteric section with. Totaly 120 cases enrolled were randomly assigned to a lateral decubitus position group and supine position group. The ufn is preferably used with the unreamed technique while, since it is cannulated, the cfn is primarily used with the reamed technique using a guide wire.
This study aims to evaluate use of the russelltaylor reconstruction nail rtrn in this group with regard to mortality risk, complication rates and final outcome. For reconstructive nailing, overreaming the entire canal 1. Inserting the blade to the stop is important, as the impactor must click into the protection sleeve. Browse our femoral nails catalogue online and request a free quote now.
Sixteen patients had proximal femoral fractures and 23 patients had femoral metastases. In two cases refixation was achieved with a dynamic hip screw dhs and a. Lengthening of the femur over an existing intramedullary nail. The surgeon must check that the package has not been damaged and has not expired.
All surgical techniques are available as pdf files at. Nov 19, 2016 the proximal femoral nail pfn ortho tube. This technique uses the principles of lengthening over an imn. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. Proximal femoral nail antirotation surgical technique depuy synthes 33. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients j. Mechanical failures after fixation with proximal femoral nail. To estimate the nail diameter, place the template on the lateral xray of the uninjured femur and measure the dia. Tfn titanium trochanteric fixation nail system surgical technique depuy synthes. Besides the t2 femoral nail with a 3m radius of curvature, stryker offers also a 1. In three subtrochanteric femoral fractures ao classification 31 a. This material is intended for the sole use and benefit of the biomet sales force and health care.
The femoral antegrade nail fan technique changes with respect to nail entry point and insertion technique. Reason and treatment of failure of proximal femoral nail. Ufn unreamed femoral nail cfn cannulated femoral nail. The purpose of this metaanalysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate. This surgical technique is written from the trochanteric antegrade nail tan perspective. Early full weightbearing the construction of the pfn even in tan permits early full weightbearing. Getting the trajectory of the proximal femoral nail in the right direction is essential to achieve a good result in the technically demanding surgery of proximal femoral fracture. 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. Original article is proximal femoral nail antirotation. Fractures involving the intertrochanteric region and subtrochanteric fractures were excluded, as open reduction was required.
The unreamed femoral nail ufn and the cannulated femoral nail cfn are used to stabilize diaphyseal and metaphyseal fractures of the femur. Femoral universal femoral universal nailing system options. Proximal fixation first technique surgery is performed in the modified beach chair or lazylateral position on a beanbag and radiolucent. Lavini f, renzi brivio l, aulisa r, cherubino f, di seglio pl, galante n, leonardi w, manca m.
In 2004, the aoasif group developed the proximal femoral nail antirotation pfna to improve the rotational and angular stability with one single element. We export and supply high quality proximal femoral nail pfn at best price. The incidence of intertrochanteric fractures is gender and racedependent and varies from country to country. The tfnadvanced proximal femoral nailing system tfna solution. Antegrade femoral nail afn surgical technique 11 p a determine nail insertion point and insert guide wire in the ap view, the nail insertion point is normally found on the tip or slightly lateral to the tip of the greater trochanter in the curved extension of the medullary cavity. Unstable proximal femoral fractures and pathological lesions involving the trochanteric region in the elderly comprise an increasing workload for the trauma surgeon as the ageing population increases. Pdf in 1996, the aoasif developed the proximal femoral nail pfn as an intramedullary device for the treatment of unstable per, intra and. Proximal femoral nail in reverse trochanteric femoral. Gadegone1, bhaskaran shivashankar2, vijayanad lokhande3, and yogesh salphale3 1 department of orthopaedic and traumatology, associate professor of orthopaedics, gmc, 442402 chandrapur, maharashtra, india. Oct 01, 20 intertrochanteric fractures hip fracture 1.
Proximal femoral nail pfn manufacturing company from india. Proximal femoral nail versus dynamic hip screw fixation for. In this study, 36 elderly patients with hip fracture were randomly assigned to receive. Common 5mm cortical screws simplify the surgical procedure and promote a minimally invasive approach. Apr 06, 2018 pfna nail surgical technique animation created by kems studio. The treatment of stable and unstable proximal femoral fractures with a new trochanteric nail. Mar 03, 2015 prevention and treatment of these complications requires a sound understanding of the anatomy of the femur and the design specifications of femoral intramedullary nails. Pitfalls and complications in the use of the proximal femoral. The success of proximal femoral nail depended on good surgical technique, proper instrumentation and good carm visualization.
Dynamic hip screw dhs and gamma nail were commonly used but often associated with some complications, such as fixation failure and implantrelated fractures. Randomised comparison of the gamma nail and the pfn. Implant breakage of the proximal femoral nail pfnreasons. However, the use of the nail is technically ambitious and is accompanied by some risks of error, which can lead to failure of the osteosynthesis. The remotecontrolled magnetic intramedullary nail is a telescopic implant that contains a magnet that turns a gear box to induce controlled elongation of the nail.
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