Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old
Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-06-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/2151459320936444 |
| _version_ | 1818279685028577280 |
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| author | Tomohiro Matsumura MD, PhD Tsuneari Takahashi MD, PhD Mitsuharu Nakashima MD Yoshiya Nibe MD Katsushi Takeshita MD, PhD |
| author_facet | Tomohiro Matsumura MD, PhD Tsuneari Takahashi MD, PhD Mitsuharu Nakashima MD Yoshiya Nibe MD Katsushi Takeshita MD, PhD |
| author_sort | Tomohiro Matsumura MD, PhD |
| collection | DOAJ |
| description | Introduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Materials and Methods: This study involved a retrospective analysis of data on trochanteric hip fracture patients who had undergone internal fixation from March 2016 to June 2018. The inclusion criteria were patients >70 years old with trochanteric hip fractures who could walk independently before the injury and were followed up for ≥3 months after surgery. Initially, 124 patients were identified, but 33 of these were excluded because other implants were used for internal fixation. Of the remaining 91 patients in whom PFNs were used at the time of internal fixation who were included for the perioperative evaluation, 66 patients followed up for ≥3 months were included in the clinical evaluations. Results: The average surgical time was 56.8 ± 19.6 minutes (range, 23-123 minutes). The average blood loss was 89 ± 41 mL (range, 0-245 mL). The union rate was 98%. Discussion: There were no cases of nail jamming, and all nails were successfully inserted below the end of the distal isthmus without additional reaming to dilate the canal. Conclusions: Proximal femoral nails were a useful implant in Japanese elderly patients with trochanteric hip fractures and gave comparable clinical outcomes despite the femoral length being short and occurrence of intensive bowing. |
| first_indexed | 2024-12-12T23:37:15Z |
| format | Article |
| id | doaj.art-020dccb19efb40dda46fb10f57946ea1 |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-12-12T23:37:15Z |
| publishDate | 2020-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-020dccb19efb40dda46fb10f57946ea12022-12-22T00:07:23ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932020-06-011110.1177/2151459320936444Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years OldTomohiro Matsumura MD, PhD0Tsuneari Takahashi MD, PhD1Mitsuharu Nakashima MD2Yoshiya Nibe MD3Katsushi Takeshita MD, PhD4 Jichi Medical University Hospital Life Saving Emergency Center, Shimotsuke, Japan Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan Department of Orthopedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, JapanIntroduction: The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to obtain better stability for patients with trochanteric hip fractures without increasing surgical time and amount of blood loss. However, there are currently no studies concerning clinical and radiological outcomes of patients treated using these proximal femoral nails (PFNs) that have been performed in the Japanese population. The aim of this study was to retrospectively evaluate the clinical outcomes associated with 235 to 240 mm PFNs for Japanese patients >70 years old with trochanteric hip fractures who could walk independently before the injury. Materials and Methods: This study involved a retrospective analysis of data on trochanteric hip fracture patients who had undergone internal fixation from March 2016 to June 2018. The inclusion criteria were patients >70 years old with trochanteric hip fractures who could walk independently before the injury and were followed up for ≥3 months after surgery. Initially, 124 patients were identified, but 33 of these were excluded because other implants were used for internal fixation. Of the remaining 91 patients in whom PFNs were used at the time of internal fixation who were included for the perioperative evaluation, 66 patients followed up for ≥3 months were included in the clinical evaluations. Results: The average surgical time was 56.8 ± 19.6 minutes (range, 23-123 minutes). The average blood loss was 89 ± 41 mL (range, 0-245 mL). The union rate was 98%. Discussion: There were no cases of nail jamming, and all nails were successfully inserted below the end of the distal isthmus without additional reaming to dilate the canal. Conclusions: Proximal femoral nails were a useful implant in Japanese elderly patients with trochanteric hip fractures and gave comparable clinical outcomes despite the femoral length being short and occurrence of intensive bowing.https://doi.org/10.1177/2151459320936444 |
| spellingShingle | Tomohiro Matsumura MD, PhD Tsuneari Takahashi MD, PhD Mitsuharu Nakashima MD Yoshiya Nibe MD Katsushi Takeshita MD, PhD Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old |
| title_full | Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old |
| title_fullStr | Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old |
| title_full_unstemmed | Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old |
| title_short | Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old |
| title_sort | clinical outcome of mid length proximal femoral nail for patients with trochanteric hip fractures preliminary investigation in a japanese cohort of patients more than 70 years old |
| url | https://doi.org/10.1177/2151459320936444 |
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