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Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail?
BACKGROUND: There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) for pertrochanteric femoral fracture (PFF) in elderly patients. AIM: To evaluate both clinical and radiographic ou...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672801/ https://www.ncbi.nlm.nih.gov/pubmed/33269214 http://dx.doi.org/10.5312/wjo.v11.i11.483 |
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author | Baek, Seung-Hoon Baek, Seunggil Won, Heejae Yoon, Jee-Wook Jung, Chul-Hee Kim, Shin-Yoon |
author_facet | Baek, Seung-Hoon Baek, Seunggil Won, Heejae Yoon, Jee-Wook Jung, Chul-Hee Kim, Shin-Yoon |
author_sort | Baek, Seung-Hoon |
collection | PubMed |
description | BACKGROUND: There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) for pertrochanteric femoral fracture (PFF) in elderly patients. AIM: To evaluate both clinical and radiographic outcomes after fixation with PFN and PFNA in an elderly patient population. METHODS: One hundred fifty-eight patients older than 65 years with PFF who underwent fixation with either PFN or PFNA were included. Seventy-three patients underwent fixation with PFN, whereas 85 were fixed with PFNA. The mean follow-up was 2.4 years (range, 1-7 years). Clinical outcome was measured in terms of operation time, postoperative function at each follow-up visit, and mortality within one year. Radiographic evaluation included reduction quality after surgery, Cleveland Index, tip-apex distance (TAD), union rate, time to union, and sliding distance of the screw or blade. Complications including nonunion, screw cutout, infection, osteonecrosis of the femoral head, and implant breakage were also investigated. RESULTS: Postoperative function was more satisfactory in patients who underwent PFNA than in those who underwent PFN (P = 0.033). Radiologically, the sliding difference was greater in PFN than in PFNA patients (6.1 and 3.2 mm, respectively, P = 0.036). The rate of screw cutout was higher in the PFN group; eight for PFN (11.0%) and two for PFNA patients (2.4%, P = 0.027). There were no differences between the two groups in terms of operation time, mortality rate at one year after the operation, adequacy of reduction, Cleveland Index, TAD, union rate, time to union, nonunion, infection, osteonecrosis, or implant breakage. CONCLUSION: Elderly patients with PFF who underwent PFNA using a helical blade demonstrated better clinical and radiographic outcomes as measured by clinical score and sliding distance compared with patients who underwent PFN. |
format | Online Article Text |
id | pubmed-7672801 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-76728012020-12-01 Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? Baek, Seung-Hoon Baek, Seunggil Won, Heejae Yoon, Jee-Wook Jung, Chul-Hee Kim, Shin-Yoon World J Orthop Retrospective Study BACKGROUND: There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) for pertrochanteric femoral fracture (PFF) in elderly patients. AIM: To evaluate both clinical and radiographic outcomes after fixation with PFN and PFNA in an elderly patient population. METHODS: One hundred fifty-eight patients older than 65 years with PFF who underwent fixation with either PFN or PFNA were included. Seventy-three patients underwent fixation with PFN, whereas 85 were fixed with PFNA. The mean follow-up was 2.4 years (range, 1-7 years). Clinical outcome was measured in terms of operation time, postoperative function at each follow-up visit, and mortality within one year. Radiographic evaluation included reduction quality after surgery, Cleveland Index, tip-apex distance (TAD), union rate, time to union, and sliding distance of the screw or blade. Complications including nonunion, screw cutout, infection, osteonecrosis of the femoral head, and implant breakage were also investigated. RESULTS: Postoperative function was more satisfactory in patients who underwent PFNA than in those who underwent PFN (P = 0.033). Radiologically, the sliding difference was greater in PFN than in PFNA patients (6.1 and 3.2 mm, respectively, P = 0.036). The rate of screw cutout was higher in the PFN group; eight for PFN (11.0%) and two for PFNA patients (2.4%, P = 0.027). There were no differences between the two groups in terms of operation time, mortality rate at one year after the operation, adequacy of reduction, Cleveland Index, TAD, union rate, time to union, nonunion, infection, osteonecrosis, or implant breakage. CONCLUSION: Elderly patients with PFF who underwent PFNA using a helical blade demonstrated better clinical and radiographic outcomes as measured by clinical score and sliding distance compared with patients who underwent PFN. Baishideng Publishing Group Inc 2020-11-18 /pmc/articles/PMC7672801/ /pubmed/33269214 http://dx.doi.org/10.5312/wjo.v11.i11.483 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Baek, Seung-Hoon Baek, Seunggil Won, Heejae Yoon, Jee-Wook Jung, Chul-Hee Kim, Shin-Yoon Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title | Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title_full | Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title_fullStr | Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title_full_unstemmed | Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title_short | Does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
title_sort | does proximal femoral nail antirotation achieve better outcome than previous-generation proximal femoral nail? |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672801/ https://www.ncbi.nlm.nih.gov/pubmed/33269214 http://dx.doi.org/10.5312/wjo.v11.i11.483 |
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