The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other. With respect to osteosynthetic stabilization a proximal femoral antirotation nail with a spiral blade pfna, synthes, oberdorf, switzerland was used in two cases and cephalomedullary nail sirus, zimmer, freiburg, germany in the remaining ten patients. Proximal femoral nail antirotation devices pfnas are considered biomechanically superior to dynamic hip screws for treating unstable peritrochanteric fractures and reportedly have a lower complication rate. This is a fusion procedure of the big toe joint using a plate and screws for fixation. Sites at highest risk of fracture include the hipfemur and pelvis in females, and vertebrae in males with anorexia nervosa. Proximal femoral nail antirotation in treatment of fractures. The mediallateral angle of 6 allows insertion at the tip of the greater trochanter. Such complications are induced by the migration of screws in opposite directions, which may lead to failure of the osteosynthesis.
Free fulltext pdf articles from hundreds of disciplines, all in one place comparison of proximal femoral nail antirotation pfna with ao dynamic condylar screws dcs for the treatment for unstable peritrochanteric femoral fractures pdf paperity. Should the tipapex distance tad rule be modified for. Ma721 mr0 f1 510k summary of safety and effectiveness. Dynamic hip screw dhs or sliding screw fixation is a type of orthopaedic implant designed for fixation of certain types of hip fractures which allows controlled dynamic sliding of the femoral head component along the construct.
The rate of complications using pfnaii is lower than pfna for the treatment of unstable. In our practice, we always try to use the recommended entry point for the pfna ii according to the manufacturers suggested surgical technique. Synthes oberdorf, switzerland, was developed by the aoasif group. Tfnadvanced proximal femoral nailing system tfna the tfna system is designed to advance the treatment of trochanteric fractures by providing surgical options that help to preserve bone in insertion area due to reduced critical width, improve anatomical fit 1 and increase implant strength. Feb 27, 20 to achieve rotational and angular stability, in 2004, the proximal femoral nail antirotation pfna device, one of the thirdgeneration intramedullary implants pfna. Download fulltext pdf the pfna proximal femur nail in treatment of unstable proximal femur fractures3 cases of postoperative perforation of the helical blade into the hip joint. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. Often, these are treated with intramedullary nails. The nail design has been well proven in over 450 000 cases performed with the pfn and pfna. Fixation of trochanteric hip fractures using the gamma nail has been performed since 1988 and is today well established and widespread. Mechanical failures after fixation with proximal femoral. The recovery time is about 7 weeks in a walking boot and the another 5 weeks in a gym shoe.
Complete traumatic backout of the blade of proximal femoral nail. The details concerning the classification of fractures are based on the ao fracture classification. Pfna ii nail several distal locking options static or dynamic locking can be performed via the aiming arm with pfna ii standard, small and xs. The proximal femoral nail antirotation pfna device was recently introduced as an option for intramedullary management of pertrochanteric hip fractures. Intertrochanteric fracture with lowenergy trauma in a. Entry point soft tissue damage in antegrade femoral nailing. A total of 2 consecutive patients with unstable trochanteric. Ufn unreamed femoral nail cfn cannulated femoral nail. We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. Pfna kurz pfna lang statisch dynamisch statisch dynamisch 2 synthes pfna.
A 29yearold woman known to have suffered from anorexia nervosa 15 years ago visited the emergency department due to right hip pain after. The blade prevents rotation or compaction of the proximal fragment by locking with the nail rotationally. The decreased mediolateral angle of the pfna ii 5 compared with 6 for the pfna and its. Pfna depuy synthes pdf catalogs technical documentation. Synthes tfn implant 211 synthes tfn implant 211 click to enlarge. Comparison of proximal femoral nail antirotation pfna with. However, it is unclear whether the new design in fact avoids lateral cortex impingement. All surgical techniques are available as pdf files at. The aoasif proximal femoral nail antirotation pfna. Of the many complications following anorexia nervosa, low bone mineral density bmd is a significant risk factor for fractures. The medical implant is mainly fabricated using stainless steel and titanium alloys for strength and the plastic coating that is done on it acts as an artificial cartilage. Cement augmentation of the proximal femoral nail antirotation.
Howmedica gamma nail implant 282 original gamma nail. Ctncannulated tibianai system is a universal straight lntramedullaryim nai with a 50 proximal and distal bend configuration to fit the anatomy of the tibia and is inserted proximallyantegrade over 3. To achieve rotational and angular stability, in 2004, the proximal femoral nail antirotation pfna device, one of the thirdgeneration intramedullary implants pfna. Depuy synthes impactor for pfna proximal femoral nail. Designed to advance the treatment of hip fractures. Comparison of proximal femoral nail antirotation pfna. Review of proximal nail antirotation pfna malaysian.
An orthopedic implant is a medical device manufactured to replace a missing joint or bone or to support a damaged bone. The flexible tip eases insertion and avoids stresses at the. Age 75 years and older closed unstable trochanteric fracture. Pfna2 intertan the pfnaii has a quite good anatomic fit and its helical blade enhances bone purchase in the femoral neckhead. The nail is cannulated, is 10 mm thick and is available in three lengths with a distal dynamic opening. Proximaler femurnagel antirotation operationstechnik. The synthes proximal femoral nail antirotation pfna is unique because it is the only proximal femoral intramedullary nail which employs a helical blade in lieu of a. Nov 17, 2011 proximal femoral nail antirotation pfna versus pfna augmentation the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Depuy synthes impactor for pfna proximal femoral nail anti. The paper describes three cases of pertrochanteric fractures. Aug 17, 2017 all lots of the depuy synthes impactor for pfna blade pn 03. Gleichseitige ausgepragte coxarthrose, frakturen im wachstumsalter mit.
Proximal femoral nail antirotation surgical technique pfna. The pfna augmented in revision surgery of proximal femur fractures. Anorexia nervosa is a chronic psychiatric disease defined by severe weight loss, due to fear of obesity, and selfimposed semistarvation. Pdf the pfna proximal femur nail in treatment of unstable.
We conducted a randomized prospective study to compare the functional and radiological outcome of proximal femoral nail antirotationasiapfnaii and dynamic hip screw dhs used in fixation of stable ao type 31 a1a2. Biomechanical characterization of osteosyntheses for proximal fractures. Innomed hip instruments surgical tools other useful. Pfna, designed by ao in 2004, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head 2, 3.
Newer implants for geriatric hip fractures authorstream. Synthes, oberdorf, switzerland is an intramedullary device with a helical blade that was developed by aoasif. Unstable proximal femoral fractures are common and challenging for the orthopaedic surgeon. Oct 17, 20 unstable proximal femoral fractures are common and challenging for the orthopaedic surgeon. This site is published by the depuy synthes companies, which are solely responsible for its content. Failure of fixation of trochanteric femur fractures.
The synthes proximal femoral nail antirotation pfna is unique because it is the only proximal femoral intramedullary nail which employs a helical blade in lieu of a lag screw. Pdf proximal femoral nail antirotation in treatment of. Cephalic intramedullary nails with proximal antirotation device are the treatment of choice for such patients. In the synthes pfna technique guide, it underlines removing and replacing the blade if it cannot be locked intraoperatively. Fixation of the pertrochanteric hip fractures of these 23 patients with the synthes pfna was performed by 6 experienced orthopaedic surgeons. Anorexia nervosa is associated with higher risk of incident fracture in females across all age groups, and in males. Does pfna ii avoid lateral cortex impingement for unstable. Anatomy of the medial femoral circumflex artery and its surgical implications. Pdf the proximal femur nail antirotation represents a new generation of.
If the pfna cannot be inserted, select a smaller size pfna diameter or ream the medullary cavity to a. Unstable trochanteric fractures have been an enigma for the orthopedic surgeon in the community because of unpredictable results. Tennessee and the proximal femoral nail antirotation pfnaii synthes, solothurn, switzerland. Zeffect and reverse zeffect are complications that arise from the surgical treatment of pertrochanteric fractures of the femur with proximal femoral nails pfn comprising two interlocking head screws. Proximal femoral nail antirotation technique guide pfna. Depuy synthes, oberdorf, switzerland have been welldocumented in recent studies 8, 9, 10.
All these factors of the pfnaii allow the patients to bear partial weight sooner after the surgery. The purpose of this study was to introduce a new surgical technique, that involves modified candypackage wiring followed by im nailing fixation and to determine the clinical and radiological results obtained in patients with unstable intertrochanteric fractures with a lesser trochanter fragment. May 31, 2014 examples include the gamma nail strykerhowmedica, the intramedullary hip screw smith and nephew richards, the proximal femoral nail synthes and the ace trochanteric nail depuy orthopaedics. Surgical treatment of pathological fractures occurring at the. With augmentation option surgical technique depuy synthes 5 pfna nail product range the pfna is available in 4 sizes pfna long, length 300 420 mm, with 20 mm increments, bending radius 1. The surgery was prolonged due to the jamming of the implants. Implants all intramedullary implants for the femur cfn cannulated femoral nail standard locking tan titaniumaluminiumniobium alloy, cannulated, for procedures with or without reaming. Should the tipapex distance tad rule be modified for the. Proximal femoral nail antirotation pfna versus pfna augmentation the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. New advanced nailing system from depuy synthes companies. First, first, perform the closed reduction of the fracture fragments. The instrument has a blunt tip with a 2mm cablewire hole, and a large handle to accommodate the use of two hands if desired.
Jan 18, 20 in our practice, we always try to use the recommended entry point for the pfna ii according to the manufacturers suggested surgical technique. If the inline pdf is not rendering correctly, you can download the pdf file here. Depuy synthes impactor for pfna proximal femoral nail antirotation blade mda2017. Proximal femoral nail antirotation in treatment of. This procedure is very predictable and has been well documented in the literature. A 94yearold woman sustained an intertrochanteric fracture of the left femur. Pdf bipolar hemiarthroplasty should not be selected as. Intertrochanteric fracture with lowenergy trauma in a young. Proximal femoral nail pfna blade rotational and angular stability achieved with one single element compaction of cancellous bone nserting the pfna. So with the help of xl3dss 3d laser scanner shining 3d, hangzhou. The asia proximal femoral nail antirotation versus the standard. Surgical treatment of pathological fractures occurring at.
In three patients curettage and cementation was performed additionally. Carefully insert the pfna manually as far as possible into the femoral opening. Wiring technique for lesser trochanter fixation in proximal. In five cases revision surgery was performed because of a loosening of the femoral neck implant, in two cases because of a pseudarthrosis, in two cases because of an implant failure and in one case because of a new fracture with the implant being in situ summarized. The most common mode of failure of any device to treat these fractures is cutout. Is pfnaii a better implant for stable intertrochanteric. About synthes tfn implant 211 trochanteric fixation nail tfn ap view. Usa was performed o n traction tables in a supine position under carm uor os copy. Internal fixation is an operation in orthopedics that involves the surgical implementation of implants. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. Pfna nail optimal fit the anatomical design guarantees an optimal fit in the femur. Several distal locking options static or dynamic locking can.
The blade and nail were eventually removed and replaced with an alternative product. Pdf functional and radiological results of proximal. The pfna augmented in revision surgery of proximal femur. Avec option daugmentation technique guide synthes 1. Examples include the gamma nail strykerhowmedica, the intramedullary hip screw smith and nephew richards, the proximal femoral nail synthes and the ace trochanteric nail depuy orthopaedics. However, a number of reports have raised serious concerns about the implants complication rate. The synthes pfnlong is based on the pfn and partly also ufn implants. Pfna blades have been biomechanically proven to compact cancellous bone and achieve increased stability and. Functional and radiological results of proximal femoral nail antirotation pfna osteosynthesis in the treatment of unstable pertrochanteric fractures.
All lots of the depuy synthes impactor for pfna blade pn 03. Helical blade compression failure occurred during pfna implantation. Indirect cooperation can be applied to library circulation transactions to generate suggestions of items relevant to patrons and researchers. Listing a study does not mean it has been evaluated by the u. Instabile pertrochantare frakturen aoklassifikation 31a2, 31a3, subtrochantare femurfrakturen aoklassifikation 32a1, schaftfrakturen im proximalen femurdrittel. The pfna ii was introduced to eliminate lateral cortex impingement encountered with the pfna. The advantages of closed approaches to treat femoral fractures with intramedullary nails or long proximal femoral nail antirotation pfna. However, there are few clinical studies characterizing the surgical outcomes of intertrochanteric or. Ruedi tp, buckley re, moran cg 2007 ao principles of fracture management. It incorporates the best elements of our highly successful global hip nails tfn, pfna, and pfna ii, optimized through input from hundreds of surgeons. Proximal femoral nail antirotation pfna versus pfna. The dhs and pfna used in this study are supplied by synthes usa sales west chester, philadelphia, usa, and it is impossible to gain the structure, material property, or component due to the protection of intellectual property. Alternatively, you can download the file locally and open with any standalone pdf reader. This is used for an arthritic big toe joint or a severe bunion deformity.
To report outcomes of 36 consecutive patients treated with a proximal femoral nail pfna for osteoporotic trochanteric femoral fractures. We are a liquidator of sutures and other surgical items from ethicon, covidien autosuture, synthes, stryker, arthrex and are able to pass our savings on to you. The pfna synthes, hertfordshire, uk is available in four sizes standard, small, xs and long and has right and left options for the long nail. Download free book calculo aplicado hoffmann pdf file at best 20 jan 2018 pdf online download calculo aplicado hoffmann. Mechanical failures after fixation with proximal femoral nail.
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