Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study
Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture;...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2017-12-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/2151458517743327 |
| _version_ | 1818311960834342912 |
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| author | Ichiro Okano MD Takatoshi Sawada MD Nobumasa Kushima MD Tetsuya Tachibana MD Katsunori Inagaki MD, PhD |
| author_facet | Ichiro Okano MD Takatoshi Sawada MD Nobumasa Kushima MD Tetsuya Tachibana MD Katsunori Inagaki MD, PhD |
| author_sort | Ichiro Okano MD |
| collection | DOAJ |
| description | Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture. The aim of this study is to assess the effectiveness of helical blade CMN for basicervical fracture in elderly patients. Methods: We conducted a retrospective review of 500 consecutive extracapsular fracture patients treated surgically between January 2005 and February 2015. Patients who had trochanteric extension or multifragment fracture were excluded. Sixteen cases of 2-part basicervical proximal femoral fracture were identified. All patients were treated with the same single helical blade CMN system (DePuy Synthes PFNA-II). Implant-related complications were recorded. Results: Two patients dropped out during follow-up and 14 patients were included in the analysis. The average follow-up period was 21.9 months. No major complication was observed. The patients were subcategorized into 2 groups: nondisplaced (displacement <2 mm at any point of the fracture line) or displaced. Excessive telescoping was observed in 2 patients, both of whom were in the displaced fracture group. The overall implant-related complication rate was 14.2% (2/16). Conclusion: Internal fixation with the helical blade CMN system can be considered as a treatment option for 2-part basicervical proximal femoral fracture in elderly patients. |
| first_indexed | 2024-12-13T08:10:16Z |
| format | Article |
| id | doaj.art-912c940431384bf0b0e0dfa1be488a06 |
| institution | Directory Open Access Journal |
| issn | 2151-4585 2151-4593 |
| language | English |
| last_indexed | 2024-12-13T08:10:16Z |
| publishDate | 2017-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-912c940431384bf0b0e0dfa1be488a062022-12-21T23:54:14ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45852151-45932017-12-01810.1177/2151458517743327Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational StudyIchiro Okano MD0Takatoshi Sawada MD1Nobumasa Kushima MD2Tetsuya Tachibana MD3Katsunori Inagaki MD, PhD4 Department of Orthopaedic Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan Department of Orthopaedic Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan Department of Orthopaedic Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan Department of Orthopaedic Surgery, Ohta Nishinouchi Hospital, Koriyama, Japan Department of Orthopaedic Surgery, Showa University, School of Medicine, Tokyo, JapanBackground: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture. The aim of this study is to assess the effectiveness of helical blade CMN for basicervical fracture in elderly patients. Methods: We conducted a retrospective review of 500 consecutive extracapsular fracture patients treated surgically between January 2005 and February 2015. Patients who had trochanteric extension or multifragment fracture were excluded. Sixteen cases of 2-part basicervical proximal femoral fracture were identified. All patients were treated with the same single helical blade CMN system (DePuy Synthes PFNA-II). Implant-related complications were recorded. Results: Two patients dropped out during follow-up and 14 patients were included in the analysis. The average follow-up period was 21.9 months. No major complication was observed. The patients were subcategorized into 2 groups: nondisplaced (displacement <2 mm at any point of the fracture line) or displaced. Excessive telescoping was observed in 2 patients, both of whom were in the displaced fracture group. The overall implant-related complication rate was 14.2% (2/16). Conclusion: Internal fixation with the helical blade CMN system can be considered as a treatment option for 2-part basicervical proximal femoral fracture in elderly patients.https://doi.org/10.1177/2151458517743327 |
| spellingShingle | Ichiro Okano MD Takatoshi Sawada MD Nobumasa Kushima MD Tetsuya Tachibana MD Katsunori Inagaki MD, PhD Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study |
| title_full | Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study |
| title_fullStr | Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study |
| title_full_unstemmed | Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study |
| title_short | Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study |
| title_sort | treatment with helical blade cephalomedullary nail for two part basicervical proximal femoral fracture in elderly patients a retrospective observational study |
| url | https://doi.org/10.1177/2151458517743327 |
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