This is a prospective observational study conducted at orthopaedic surgery department. The effect of the cerclage wire in the treatment of subtrochanteric femur fracture with the long proximal femoral nail. Proximal femoral nail antirotation pfnatm fixation of extra. Proximal femoral nail antirotation pfnatm fixation of. Combining a hip pin which provides rotational stability with a loadbearing femoral neck screw ensures intra and postoperative safety. Mechanical failures after fixation with proximal femoral nail and risk factors article pdf available in clinical interventions in aging 10issue 1 december 2015 with 238 reads. How to avoid common mistakes while doing pfn duration.
The treating surgeon is responsible for determining the appropriate treatment, technique s, and products for each individual patient. The treatment of stable and unstable proximal femoral fractures with a new trochanteric nail. Fit the alignment rod with the resection guide and arm. Role of proximal femoral nail in the treatment of unstable. Pfn nails ask price proximal femoral nail pfn are used to fix pertrochanteric, intertrochanteric, high subtrochanteric and transcervical fractures of the femur. Over 1 million times per year, biomet helps one surgeon provide personalized care to one patient. Standard pfn and long pfn simple, reliable, versatile surgical technique. An expandable self locking nailing system no distal screws required. Proximal femoral nail antirotation surgical technique depuy synthes 11 2 confirm nail length and diameter instrument 309. Surgical treatment of dementia patients following undisplaced femur neck fractures. Clinicoradiological and functional outcome of unstable.
Pedinail surgical technique nail placement attach the preselected nail to the targeting device with the attachment bolt fig. Mechanical failures after fixation with proximal femoral. Pdf proximal femoral nail antirotation in treatment of. Insert the nail until the nail tip protrudes only slightly into the humeral head. Surgical technique for pediatric femur fractures the nancy nail 2. Surgeon was experienced in passing second genera tion intramedullary nails for femoral shaft fractures as. The new proximal femoral nail antirotation pfnar in daily practice. Midterm outcomes after intramedullary fixation of peritrochanteric femoral fractures using the new proximal femoral nail antirotation pfna. This site is like a library, you could find million book here by using search box in the header. Health, general hip fractures care and treatment hip joint fractures orthopedic fixation devices comparative analysis. The talon distalfix proximal femoral nail talonpfn is a new proximal femoral intramedullary nail designed for the treatment of intertrochanteric femoral fractures. This study was conducted to compare the functional and radiological outcome of proximal femoral nail pfn with dynamic hip screw dhs in treatment of type ii intertrochanteric fractures boyd and griffin classification.
Proximal femoral nail pfn are used to fix pertrochanteric, intertrochanteric, high subtrochanteric and transcervical fractures of the femur. Outcomes of trochanteric femoral fractures treated with proximal femoral nail. The pfna device is a proximal reconstruction nail that is anchored in the femoral head by a helical blade. Proximal femoral nail antirotation surgical technique depuy synthes 1 table of contents introduction surgical technique product information. Depuy synthes ecatalog valid globally, except for usa and canada. Our results indicate the necessity of a careful surgical technique and modifications that are specific to.
Ao surgery reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. Proximal femoral nail antirotation in treatment of fractures of. The mean operative time for patients who had a2 fracture was 62. Inserted in a reduced diameter and expanded within the medullary canal. All patients had surgery within 48 hours of admission. The criteria for the assessment of efficiency of surgical technique included. 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 major development is the helical blade which is supposed to compress the surrounding cancellous bone in the femoral neck and stabilise the head and neck. The talon distalfix proximal femoral nail system features an advanced distal fixation method with patented talon technology, which eliminates the use of cortical locking screws. Numerous variations of intramedullary nails have been devised to achieve a stable fixation and early mobilisation of pertrochanteric fractures, among these the proximal femoral nail pfn devised by the aoasif group in 1996 has proven to be a promising implant in per, inter or subtrochanteric femoral fractures.
After an appropriate anesthesia, the patients were. Long nail all nails use the same lag screws, set screw, distal locking screws and end caps see fig. Clinical and radiological outcomes of patients treated. The aequalis humeral nail can be used either percutaneously or in open surgery. Proximal femoral nail pfn specification, uses, sizes and surgical techniques proximal femoral nail pfn specification rotational stability. Affixus hip fracture nail surgical technique zimmer biomet. It shares the advantage of the small distal shaft diameter with the pfn 15. Trigen intertan technique utilizing the gold instrument set. Surgical technique implant selection the trigen intertan nail preoperative template set 71674200 may be used to assist with preoperative implant selection. Few studies have assessed this method of cephalic fixation, which theoretically ensures rotational and angular stability with a single component, as well as cancellous bone compaction around the blade inserted by impaction. When one surgeon connects with one patient to provide personalized care, the promise of medicine is ful lled. Interlocking nailing is an orthopaedic technique involving the insertion of a metal rod. Vinay kumar singh, nims and evaa hospitals, jaipur, india. Solid humeral nail uhn and proximal humeral nail phn.
The three neckshaft angles accommodate variations in femoral neck anatomy. Get explanatory answers from our book, evidence based medicine exam module. Report by journal of evolution of medical and dental sciences. We conclude that the proximal femoral nail antirotation 2 pfna2 was an ideal implant for unstable intertrochanteric fractures, leading to high rate of bone union restoring the lateral femoral wall, reducing the chances of implant failure and decreasing the post. A comparative study of reconstruction nailing versus. Then you can start reading kindle books on your smartphone, tablet, or computer no kindle device required. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. The pfna augmented proximal femoral nail antirotation, synthes inc. Proximal femoral nail right femur a live transmission from. 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. Author links open overlay panel bekir eray kilinc a yunus oc b adnan kara c ramazan erden erturer d. Results of the proximal femoral nail antirotation pfna. At present, we consider that the pfn is an acceptable and minimally invasive implant for unstable proximal femoral fractures. Operative technique t2 proximal humeral nailing system.
Surgical technique included closed reduction if there was large spiral subtrochanteric fragment, minimal ac cess reduction was done using a bone holding forceps and closed intramedullary nailing with proximal femoral nail. The surgical technique is not complex, the number of. The proximal femoral nail antirotation pfna system is a new device introduced by the aoasif in 2003. The proximal femoral nail antirotation, known as the pfna, is an intramedullary implant for the treatment of unstable trochanteric femoral fractures. Totaly 120 cases enrolled were randomly assigned to a lateral decubitus position group and supine position group. Functional and radiological results of proximal femoral nail. Proximal femoral nailing in communited intertrochanteric fractures is increasingly becoming popular in view of superior biomechanics and prevention of varus collapse associated with dynamic hip screw. Nail size, screw length and femoral neck angle may be determined. Not many studies compare the dhs with proximal femoral nail pfn, which is being preferred by many. Contour both nails into a bow shape with the nail tip pointing to the concave side of the bowed nail. Mechanical failures after fixation with proximal femoral nail. A comparative study of reconstruction nailing versus dynamic hip screw device in the surgical management of intertrochanteric fractures.
Standard pfn and long pfn simple, reliable, versatile. Once inserted, a slap hammer adapter andor slap hammer may be used to fully insert the nail, if preferred. Proximal femoral nail right femur a live transmission from the ao course 1996 2 6 dec davos. View of a study on surgical management of unstable. Nail surgery is not frequently performed in medical practice, by general practitioners, surgeons or dermatologists. Solid and cannulated nails technique guide synthes synthes on. Enter your mobile number or email address below and well send you a link to download the free kindle app.
Proximal femoral nail antirotation in treatment of. Ptn insertion there is no need to exchange the guide wire prior to nail insertion. Esin therefore can be achieved very effectively with nancy nails. The apex of the curve, after bending, must be at the level of the fracture. A total of 152 patients with hip fractures who underwent osteosynthesis. The proximal femoral nail antirotation pfna, designed by ao, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head and was tested in a. Instruction by a surgeon experienced in handling this instru.
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. Surgical technique for standard pfn proximal femoral nail standard pfn and long pfn 12 1. All books are in clear copy here, and all files are secure so dont worry about it. Determine the ccd angle using a goniometer or the preoperative planning template. Elastic stable intramedullary nailing esin is an established philosophy for treatment of long bone fractures in children. Choose a nail of appropriate diameter, depending upon the patients age and medullary canal size see table 1.
The neff nail surgical technique for knee zimmer biomet. The order of insertion of proximal and distal screws relies on fracture types and surgeons preference. This surgical technique is written from the trochanteric antegrade nail tan perspective. The etched line on the nail will provide a reference for the. The reason is a general unease to do more than just nail avulsions although these are very rarely indicated and are no treatment at all. Outcomes of trochanteric femoral fractures treated with. The color coding system is referenced in the technique. Techniquenail insertion for pediatric femur contouring the nail additionally available item contouring may be done by hand or with the tabletop platebending press 329. Lavini f, renzi brivio l, aulisa r, cherubino f, di seglio pl, galante n, leonardi w, manca m.
The biomet peritrochanteric nail is inserted over the guide wire and into the medullary canal, by hand. Role of proximal femoral nail in the treatment of unstable intertrochanteric fractures asad khan ghilzai1, syed kamran ali shah2, muhammad ayub khan3, muhammad arsalan ghazi2 and muhammad kazim rahim najjad1. The nail design has been well proven in over 200 000 cases performed with the pfn. With augmentation option depuy synthes 1 table of contents introduction pfna. Dec 17, 2015 this study aims at assessing the clinical results, radiographic findings, and associated complications after osteosynthesis of trochanteric hip fractures with proximal femoral nail pfn.
Grooves in stainless steel nails ensure flexibility of the long pfn similar to a 12mm solid femoral nail ufn in titanium alloy with grooves. Proximal femoral nail medin basic operating procedure. Step by step instructions to achieve a perfect proximal femur pfna ii surgery. Aug 20, 2018 surgical technique of dhs fixation dhs remains the gold standard for trochanteric fractures, and is a rather quick surgery with assured and predictable results. Total 91 patients of either gender with age between 18 to 70 years had closed ao type 31a2 and 31a3 unstable intertorchanteric. Gamma3 locking nails come in 3 neck shaft angles of. This material represents the surgical technique utilized by david weisman, m.
Each nail is supplied sterile packaged together with a set screw in one box. Pfna nail surgical technique animation created by kems studio. Proximal femoral nail pfn specification, uses, sizes and. Position patient supine on an extension table or a radio lucent operating table. Treatment of trochanteric fractures with the pfna proximal. Proximal femoral nail an analysis of 100 cases of proximal femoral. These nails are made of using finest quality stainless steel, procured from the reliable vendors. Jan 28, 2016 complications after hip nailing for fractures.
Proximal femoral nail right femur a live transmission from the ao course 1996 2. Lower limb clinical and functional outcomes of treatment. The aoasif proximal femoral nail pfn is a new device designed for the treatment of the unstable trochanteric femoral fracture. To evaluate the functional outcome of unstable intertrochanteric fractures treated with proximal femoral nail while using harris hip score. However, technical difficulties and implant related complications have been described with this technique, thus we need more studies to address these issues. Randomized controlled trials of proximal femoral nail.
Be certain that the attachment bolt remains tight throughout the impaction process. Valor hindfoot fusion nail system wright medical group. Proximal femoral nail antirotation pfna is an intramedullary implant for the treatment of unstable trochanteric femoral fractures, with the additional option of augmentation. Position the carm for an ap view of the proximal femur. Bend the nail in the same direction as the spatula tips curvature. Pfn proximal femoral nail surgical technique depuy synthes 11 option. Fracture classification this surgical technique includes the surgical treatment of the following types of fractures. Surgical technique for long pfn 24 implant removal 29. Proximal femoral nail antirotation technique guide pfna. Several distal locking options static or dynamic locking can. Confirm that the nail is oriented correctly and the. Simple reduction technique of extraarticular distal radius fractures no audio percutaneous reduction of displaced extraarticular distal radius fractures surgical technique presented by joseph f.
Proximal femoral nail antirotation technique guide use the preoperative planner template for the pfna to estimate the ccd angle, nail diameter and length. Pfn nail,proximal femoral nail,pfn nail manufacturer,supplier. This website uses cookies to improve your experience while you navigate through the website. The integral talons deploy from within the medullary canal, making the free hand technique of locking screw. Take a preoperative ap radiography of the unaffected leg. We lay strong emphasis on quality while manufacturing and supplying a quality range of pfn short nails proximal femoral nail. A wall chart 97249300300 is also available to help explain the color coding system. Pfn is a novel, recent intramedullary implant based on experience with the. If the nail does not pass easily, it may be adequate to enlarge the medullary canal with the hand reamer 351. The aoasif proximal femoral nail pfn for the treatment of. A system of choices for effective treatment of proximal femoral fractures. Dynamic distal locking done will lead to axial nail subsidence and works as medoff plate 4.
The present study describes the surgical technique and early results in a. Pdf proximal femoral nail an analysis of 100 cases of proximal. Clinical report by bulletin of the nyu hospital for joint diseases. The science and art of medical care is to provide the right solution for each individual patient. Barton tm, gleeson r, topliss c, greenwood r, harries wj, chesser tj. 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. The tfna system is designed to solve a wide range of unmet needs for surgeons, or staff, and administrators. This study aimed to report the clinical and radiological outcomes of patients treated using a proximal femoral intramedullary nail with a. The effect of the cerclage wire in the treatment of. More than five years in the making, this system offers advancement in hip fracture treatment, including outcomebased design, reduced procedural complexity, and comprehensive surgical. The pfna augmented in revision surgery of proximal femur. As shown below, the nail offers the possibility for either static. The nail design has been well proven in over 450 000 cases performed with the pfn and pfna. Surgical technique product information features 2 aoasif principles of internal fixation 4 indications 5 cases 6 preoperative planning 8 opening the tibia 9 insert the nail 20 distal locking 28 proximal locking 35 insert the end cap 55 weightbearing 57 implant removal 58 implant specifications 61 implants 62 instruments 69 warning.
This publication is not intended for distribution in the usa. Our results indicate the necessity of a careful surgical technique and modifications that are specific to the individual fracture pattern in order to. The aoasif proximal femoral nail pfn for the treatment. The neff femorotibial nail surgical technique for knee arthrodesis open canal with 8mm twist drill. Hindfoot nailing, originally described in 1906 by lexer is a useful technique for the correction of deformity in the distal tibia or ankle. 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.
Therefore, a surgical technique allowing anatomic alignment and a stable fixation with early mobilization is accepted as the standard approach. Randomised comparison of the gamma nail and the pfn. Proximal femoral nail standard pfn and long pfn warning this description is not sufficient for immediate application of the instrumentation. The long nail offers the opportunity to use two distal locking screws that are inserted through the distal nail end to control rotation and telescoping. Pfna nail surgical technique animation created by kems. Proximal femoral nail antirotation in treatment of fractures of proximal femur. Note as template magnification levels are set at 117%, all measurements are estimates of true size. The femoral antegrade nail fan technique changes only with respect to the nail entry point and insertion technique. Expanded proximal portion of nail abuts and works as tsp and prevents medialisation 3.
Nail or plate fixation of intertrochanteric hip fractures. Surgical management of proximal femoral fractures by proximal. Step by step instructions to achieve a perfect proximal. Slade, iii, md associate professor and director, yale hand and upper extremity service.
127 1175 6 896 396 1588 1333 1429 822 416 1405 569 608 1620 216 195 1593 652 184 78 830 1366 1080 1628 265 1338 594 200 58 335 1347 376 565 441 1046