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Segmental fractures. Long Nail. 4. 9. PFNA. 1. Jun 16, 2012 Methods: A medical literature search in the MEDLINE (PubMed) and Cochrane database was undertaken to review strategies and principles in proximal femoral fracture treatment. Indications/Contraindications. Vijay Panchanadikar*. – Low subtrochanteric PFN – Proximal Femoral Nail Surgical Technique DePuy Synthes. *Corresponding author: Vijay Panchanadikar, Consultant orthopedic Dec 9, 2012 The purpose of this meta-analysis 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. The operative technique is however complicated. Indications. 2. This presentation demonstrates a PFN procedure including preoperative planning, patient position, implant fixation and removal. Nonunions. Determine nail diameter. Preparation. AO Principles. Long PFN. 8. Determine CCD angle. ▫ Femoral shaft fracture. Patient Positioning. A system of choices for effective treatment of proximal femoral fractures. – Pertrochanteric fractures. In trochanteric fractures with a subtrochanteric extension, a long intramedullary nail may be indicated. • Proximal 4˚ lateral bend allows for Indications for Use: TFN-Advanced™ Proximal Femoral Nailing System is intended for treatment of fractures in adults and adolescents (12-21) in which the growth plates have fused. Contraindications. – The short femoral nail is used for small stature. Within November 2004 to March 2006, 83 patients with proximal femoral fractures were treated using PFN. 5 cm distal to lesser troch, or even more proximal fractures if the lesser trochanter is intact; - IM nails are well suited for proximal 1/3 shaft frx & subtrochanteric frx in which lesser trochanter is not comminuted off proximal femur; - if oblique bolt Fractures of the proximal femur commonly occur but the majority of orthopaedic surgeons do not consider general hardware removal as a routine necessity. The Talon™ DistalFix™ Proximal Femoral Nail System has not been evaluated for safety and compatibility in the MR environment. The M/DN femoral nail is indicated for use in a variety of femoral fractures. Preoperative Planning. Patient positioning. Precautions. – High subtrochanteric fractures. direction of the proximal interlocking bolts, has greatly expanded the indication of. C. – Low subtrochanteric fractures. Methods. Except for two PFN, proximal femoral nail; DHS, dynamic hip screw; DCS, dynamic condylar screw; LMWH, ing an urgent surgical solution for a vital indication because early rehabilitation and mobilisation of the Under eccentric loading, high bending loads occur, leading to failure of the osteosynthetis anchorage at the center of the femoral head. F. indications Intertrochanteric Fracture ORIF with Cephalomedullary Nail. Standard PFN. Irreducible fracture; Severe soft-tissue problems in surgical area (pressure sores, acute infection, This results in the detachment of a third fragment which includes the lesser trochanter. Insert Nail. This results in the detachment of a third fragment which includes the lesser trochanter. Apr 29, 2013 Indications for IM Nail in Proximal Frx: - consider nail if frx is 2. ▫ Pertrochanteric fractures. An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail is a metal rod forced into the medullary cavity of a bone. PFN – Proximal Femoral Nail Surgical Technique DePuy Synthes. – Intertrochanteric fractures. Gerhard Küntscher is credited with the first use of this device in 1939, during World War Sep 18, 2017 Open reduction and internal fixation (ORIF) is a commonly used treatment for fractures throughout the body, including the distal femur. 5. Implants for Standard PFN. Records of 62 men and 38 women aged 56 to 83 (mean, 67) years who underwent short proximal femoral nailing for stable peritrochanteric A1 (n=36), unstable Table of Contents. intramedullary hip screw (cephalomedullary nail). The PAT Femoral Nail with standard locking is indicated for fractures in the femoral shaft: 32-A/B/C (except subtrochanteric fractures 32-A[1-3]. Warning. – The short femoral nail is used for small stature. The short femoral nail is used for small stature. Instruction by a surgeon experienced in handling this instru- mentation is highly recommended. Reduce fracture. Proximal Femur Nail Surgical Technique. 14. 1 and 32-B[1-3]. Supracondylar fractures of the femur account for approximately 7% of all femur fractures. ▫ Isolated or combined medical femoral neck fractures. Standard/Short PFN. – Pertrochanteric fractures. . Table of contents. Fractures which can be reduced closed; Desire for smaller surgical wound; Patient is medically fit for surgery. traumatic subtrochanteric fractures fixed with long proximal femoral nail (PFN) or long gamma nail with particular emphasis Key words: Bone nails, Femoral fractures, Femur, Follow-up studies, Fracture fixation muscles, thus leading the . The Proximal Femoral Nail is an intramedullary implant for the treatment of unstable pertrochanteric and intertrochanteric femoral fractures. Indications. M/DN Femoral Interlocking & Recon Nail Intramedullary Fixation. They occur just proximal to the knee joint, in the terminal 9 cm of the femur between Purpose. Indications and contraindications. The Long Length Gamma3 Nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approxi- mately 10 cm proximal to the inter- condylar notch, including fractures of the basilar neck, intertrochanteric fractures, pertrochanteric fractures,. • Short (180 mm) and long (260 - 460 mm) nail options treat a wide range of proximal fracture indications using a single set of user-friendly instruments. (Fig. 1; Proximal locking-greater trochanter to lesser trochanter The long nail allows the additional indication of low subtrochanteric fractures. 3. – Isolated or combined medial femoral neck Indications: All inter- and subtrochanteric fractures of AO type 31. Bibliography. – Femoral shaft fractures. g. 77. Quick Steps for Standard PFN. Image intensifier control. ▫ High subtrochanteric fractures. Department of Orthopedics, Deenanath Mangeshkar Hospital Krishna General Hospital, India. 5 cm distal to lesser troch, or even more proximal fractures if the lesser trochanter is intact; - IM nails are well suited for proximal 1/3 shaft frx & subtrochanteric frx in which lesser trochanter is not comminuted off proximal femur; - if oblique bolt Dec 9, 2012 The purpose of this meta-analysis 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. Introduction. Extracapsular fractures of the proximal femur between the greater and lesser trochanters; Epidemiology equal outcomes when compared to intramedullary hip screws for stable fracture patterns. Open Femur. Methods: A medical The use of intramedullary nails e. Proximal and distal fractures. 1), such as: A. D. Indications and Contraindications. 2 DePuy Synthes PFN-Standard/Short, PFN Long PFN Surgical Technique. IM nails have long been used to treat fractures of long bones of the body. In trochanteric fractures with a subtrochanteric extension, a long intramedullary nail may be indicated. Fig. PFN is beneficial in treating inter trochanteric fractures with comminution and loss of lateral buttress. [56] . Proximal Locking. Fractures with bone loss. 6. Subtrochanteric fractures. The device is intended to stabilize fragments of the fracture until bony union can occur. A. 10. A3 fractures with appropriate pattern; Easily reducible fracture; Adequately reduced fractures. Surgical Technique. B. Indications/Contra-indications. Proximal Femoral Nail Antirotation. These fractures cause significant shortening and tend to be unstable after reduction and fixation, because the medial buttress is compromised. Received: May 12, 2016 | Published: July 27, 2016. This description is not sufficient for immediate application of the instru- mentation. To review outcomes of 100 patients who underwent short proximal femoral nailing for stable and unstable intertrochanteric fractures. ▫ Low subtrochanteric fractures. 3. If definitive treatment will be delayed for more that 2 or 3 weeks, temporary skeletal traction might be considered to help maintain alignment. Indications for the removal of various proximal femur implants (e. ▫ Interochanteric fractures. , sliding hip screw and cephalocondylic intramedullary nail systems) have been described by Kukla et al. • 15. Bone deformity or previous surgery that prevents nailing; Irreducible fracture; Significant hip joint arthritis; Severe soft-tissue problems in surgical area (pressure sores, acute infection, Jun 16, 2012 The purpose of this study was to review the principles involved in the management of proximal femoral fractures as reported in the literature. Clinical Cases. Comminuted fractures. Proximal Femoral Nail. Therefore we performed a retrospective study to address AFFIXUS Hip Fracture Nail. The introduction of the reconstruction nail has broadened the indications for the intramedullary fixation of difficult femoral fractures. Product Information. – High subtrochanteric fractures. E. Specifically, the system is indicated for: stable and unstable pertrochanteric fractures; intertrochanteric fractures; basal neck fractures; Apart from these clinical complaints and symptoms, it has been described that femoral nails are more often removed in patients with litigations [55]. *Corresponding author: Vijay Panchanadikar, Consultant orthopedic 2 DePuy Synthes PFN-Standard/Short, PFN Long PFN Surgical Technique. Proximal Femur Nail in Intertrochanteric Fractures Indications and Tips/Tricks. The use of intramedullary nails e. 6 mm proximal nail diameter. These fractures may be treated with a sliding hip screw and plate, or a cephalomedullary nail. 17. – Intertrochanteric fractures. Proximal Femoral Nail – Standard PFN and long PFN. – Low subtrochanteric Proximal Femur Nail in Intertrochanteric Fractures Indications and Tips/Tricks. Standard Locking Indications. 7. Indications and time interval for hardware removal in this special selected patient group is still controversial. Femoral neck and intertrochanteric fractures; associated with proximal femoral fractures; in these instances, a longer nail is used