Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Baek, Seung-Hoon, Baek, Seunggil, Won, Heejae, Yoon, Jee-Wook, Jung, Chul-Hee, Kim, Shin-Yoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
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
_version_ 1783611207769391104
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
work_keys_str_mv AT baekseunghoon doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail
AT baekseunggil doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail
AT wonheejae doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail
AT yoonjeewook doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail
AT jungchulhee doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail
AT kimshinyoon doesproximalfemoralnailantirotationachievebetteroutcomethanpreviousgenerationproximalfemoralnail