Comparison of Two Proximal Femoral Nail Types in Operative Treatment of Trochanteric Fractures:  Screw versus Helical Blade


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Vahabi A. , Kılıçlı B. , Aktuğlu S. K.

2nd International Orthopedic Trauma Camp, İzmir, Turkey, 20 - 21 March 2021, pp.22

  • Publication Type: Conference Paper / Full Text
  • City: İzmir
  • Country: Turkey
  • Page Numbers: pp.22

Abstract

Comparison of Two Proximal Femoral Nail Types in Operative Treatment of Trochanteric Fractures:  Screw versus Helical Blade

 

Background:

Proximal femoral nails (PFN) are in common use with a high success rate in the surgical treatment of trochanteric fractures. The aim of this study is to compare the treatment results of two different PFN types (1: helical blade, 2: screw) in patients 50 years of age and older.

 

Material and Methods:

Patients over 50 years old who were treated with PFN between January 2013 and July 2019 were reviewed retrospectively. The minimum follow-up period for inclusion was determined as 6 months. Patients with pathological fractures, history of ipsilateral hip surgery, and patients without proper X-ray images before or  after surgery were excluded. 98 cases met the criteria. Cases were divided into 2 groups according to the type of nail used (helical blade: group 1, n = 53; screw: group 2, n = 45). Demographic characteristics, mechanical complications, reduction quality and tip-apex distances (TAD) were compared between the groups. In addition, factors affecting mechanical complications were analyzed.

Results:

There was no significant difference between the two groups in terms of demographic characteristics [gender: group 1 = 15 men / 38 women vs. group 2 = 14 men / 31 women (p = 0.761); age: group 1 = 74.8 ± 10.5 group 2 = 74.2 ± 9.0 (p = 0.502)]. There was no statistically significant difference between the two groups as of mechanical complications.  [cut-out: group 1 = 4 cases  group 2 = 6 cases; avascular necrosis: group 1 = 1 case; long-term peri-implant fracture: group 1 = 4 cases (p = 0.379)]. Overall, higher  complication rate was related to bad reduction quality  (p = 0.000) and/or inappropriate TAD (p=0.048).

Conclusion:

Results of screw and helical blade PFNs are similar in the fixation of trochanteric fractures at the age of fifty and above. Regardless of PFN type, it is necessary to achieve high reduction quality and TAD within appropriate limits in order to reduce the failure rate.

 

Keywords: trochanteric femur fracture, proximal femoral nail, screw, helical blade.