Role of Provisional Fixation of Fracture Fragments By Steinmann-Pin and Technical Tips in Proximal Femoral Nailing for Intertrochanteric Fracture
| Autor: | Kinjal J Mavani, Dhaval Patel, Mohit J Jain |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
parallel anterior sliding
varus collapse Clinical Biochemistry lcsh:Medicine 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Medicine 030212 general & internal medicine Orthodontics 030222 orthopedics Dynamic hip screw intertrochanteric translation business.industry Trauma center lcsh:R Biomechanics Implant failure General Medicine z effect excessive anteversion Harris Hip Score Orthopaedics Section Implant Intertrochanteric fracture business |
| Zdroj: | Journal of Clinical and Diagnostic Research, Vol 11, Iss 6, Pp RC01-RC05 (2017) |
| Popis: | Introduction Proximal Femoral Nailing (PFN) in Intertrochanteric Fractures (IF) is becoming the choice of implant due to better biomechanics and prevention of varus collapse associated with Dynamic Hip Screw (DHS). Technical difficulties and implant related complications are yet to be addressed. Aim To understand the technical difficulties involved in PFN and role of provisional fixation of fracture by Steinmann-pin. Materials and methods In this study, 55 patients presented to a tertiary trauma center in India with trochanteric fractures from April 2010 to March 2012 were included and treated with PFN. All patients were followed-up for two years and final outcome assessment included shortening, neck shaft angle and Harris Hip Score was done. Results In all except one, neck shaft angle greater than 130° was achieved and also maintained in the final follow up (Mean 131.1°). All fractures were united with mean shortening of 3.6 mm and average Harris Hip Score of 91 after two years. There were five complications which included one shortening, two varus collapses, one backed out screws and one reverse Z effect. Conclusion Though PFN is technically challenging, with proper technique, gives excellent results with negligible varus collapse even in unstable fractures. Three most important technical aspects are achieving good non-varus reduction, inserting nail correctly and accurate placement of lag screws. The technique of provisional fixation of fracture fragments by Steinmann-pin significantly helps in achieving these and reduces the risk of implant failure. |
| Databáze: | OpenAIRE |
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