Journal of Musculoskeletal Trauma

Original Article

A Comparative Study of TRIGENâ„¢ INTERTAN Nail (InterTAN) and Proximal Femoral Nail Antirotation 2 (PFNA2) in the Patients with Intertrochanteric Fractures: Jae Hoon Jang, Jeung Il Kim, Um Ji Kim, Nam Hoon Moon; J Korean Fract Soc 2016;29(2):128-136. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.128

PURPOSE
The primary purpose of this study was to demonstrate that the TRIGENâ„¢ INTERTAN nail (InterTAN) could show better clinical outcome compared to the proximal femoral nail antirotation 2 (PFNA2) for treatment of intertrochanteric fracture in the elderly.
MATERIALS AND METHODS
Between March 2009 and December 2013, 164 patients with intertrochanteric fractures who met our inclusion and exclusion criteria were enrolled in this study. Evaluation variables, including operation time, blood loss during the operation, incidence of perioperative complications, clinical results at the last follow-up, and radiographic findings were assessed for comparison of the 2 implants.
RESULTS
Intraoperative lateral wall fracture was significantly higher in the PFNA2 group (p<0.05) and tip apex distance was significantly higher in the InterTAN group (p<0.05). Sliding of the proximal fragment at the last follow-up was significantly higher in the PFNA2 group. However, there was no significant difference in union rate, time to union, postoperative complications, and clinical outcomes at the last follow-up between the 2 groups.
CONCLUSION
Based on these data, clinical outcomes at the last follow-up were equivalent between InterTAN and PFNA2.

Citations

Citations to this article as recorded by

Unstable Intertrochanteric Fracture: Do We Know Everything? A Review
Balaji Zacharia, Harshitha Hayavadana Udupa
SN Comprehensive Clinical Medicine.2022;[Epub] CrossRef

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Case Report

Excessive Sliding of the Helical Blade and the Femoral Neck Fracture after Insertion of Proximal Femoral Nail Anti-Rotation for Type A2 Intertrochanteric Fractures - A Case Report -: Bong Ju Park, Hong Man Cho, Ju Han Kim, Woo Jin Sin; J Korean Fract Soc 2013;26(2):151-155. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.151

Abstract PDF

Proximal femoral nail anti-rotation (PFNA) with a lag screw that is shaped like a spiral blade shape is an orthopedic implant to fix trochanteric fractures of the proximal femur. In addition the reason of the biomechanical advantages, PFNA widely been used recently. We report an 83-year-old man with excessive sliding of the helical blade and a femoral neck fracture after AO/OTA type A2 intertrochanteric fracture, which was fixed with a PFNA.

Citations

Citations to this article as recorded by

Helical Blade Locking Sleeve Disassembly Following Failed Femur Intertrochanter Fracture - A Case Report -
Soon Ho Huh, Hong-Man Cho, Ji-Yeon Park
Journal of the Korean Fracture Society.2021; 34(3): 112. CrossRef
Retrospective Comparative Study of the Intraoperative Fracture Gap Compression in the Treatment of Intertrochanteric Fracture Using Proximal Femoral Nail Antirotation
Se Jin Kim, Hong Man Cho, Jiyeon Park, Ki Yong An, Young Woo Chung, Woojin Shin
Journal of the Korean Fracture Society.2020; 33(4): 179. CrossRef
Failure of a Rotation Control Gamma 3 Lag Screw Used to Treat a Trochanteric Fracture
Kyungho Choi, Yongtae Kim, Shicheng Zhou, Jihyo Hwang
Hip & Pelvis.2018; 30(2): 129. CrossRef
Femoral neck fractures after internal fixation of trochanteric fractures with implants in situ in adults: A systematic review
Antonio Barquet, Peter V. Giannoudis, Andrés Gelink
Injury.2018; 49(12): 2121. CrossRef

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Original Articles

The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation: Jong Won Kim, Hyun Soo Park, Young Soo Jang, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae; J Korean Fract Soc 2012;25(4):257-262. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.257

Abstract PDF: PURPOSE
This study was performed to evaluate the results of treating intertrochanteric fracture with proximal femoral nail antirotation (PFNA).
MATERIALS AND METHODS
We performed PFNA on 41 intertrochanteric femur fracture patients from May 2008, to August 2010. We analyzed the operation time, blood loss, recovery of ambulatory function, T-score, the tip apex distance (TAD), the sliding distance of the blade, neck-shaft angle, and complications.
RESULTS
The mean operation time was 51 minutes and the mean amount of blood loss was 350 ml. The time to ambulation averaged 7.2 days. Thirty-two cases (79%) recovered their previous walking status at 6 months after operation. The average T-score was 3.3 and TAD was 12.3 mm (8.6~27 mm). 35 cases (87%) achieved acceptable reduction. The average amount of PFNA blade sliding was 3.3 mm. The neck-shaft angle was changed 2.6 degrees varus displacement at the final follow-up. There was one case of nonunion due to tuberculosis infection.
CONCLUSION
The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of intertrochanteric fracture of the femur.

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The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table: Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho; J Korean Fract Soc 2011;24(3):217-222. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.217

Abstract PDF

PURPOSE
The purpose of this study is to analyze the results of intertrochanteric fractures treatment with proximal femoral nail antirotation (PFNA) without using fracture tables and thereby prevent complications.
MATERIALS AND METHODS
Forty cases of intertrochanteric fracture of 39 patients that were treated with PFNA without using fracture tables between January 2008 to December 2009 were analyzed. There were 13 males and 27 females. The mean age was 76 years old. Using AO classification, 6 cases were A1, 25 cases were A2 and 9 cases were A3. The operation was done without using fracture tables at supine position. Operation time, intraoperative bleeding were checked. For the result, Cleveland index, tip apex distance, fracture site sliding rate, change of femur neck and shaft angle were evaluated. Bone union time and complications were also estimated from the follow up radiograph. Statistics were analyzed using Independent T-test.
RESULTS
The mean operation time was 40 minutes (25 to 70 minutes) and mean intraoperative bleeding was 113 cc (40 to 250 cc). The Cleveland index was shown 94% of 5, 6, 8 and 9 zone, the tip apex distance was 12.96 mm (6 to 22 mm), the fracture sliding distance was 1.9 mm (0 to 6 mm), the change of femur neck and shaft angle was 2.5 degree (0~10 degree) and the average bone union time was 15 weeks (8 to 24 weeks). The complication include 2 cases of delayed union and 2 cases of varus deformities.
CONCLUSION
We have shortened the operation time by closed reduction methods without using the fracture tables, and the complication were minimized with using simple tools like a reduction forcep or bone hook at PFNA blade insertion.

Citations

Citations to this article as recorded by

Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)
Hyeon Joon Lee, Hyun Bai Choi, Ba Rom Kim, Seung Hwan Jo, Sang Hong Lee
Journal of the Korean Fracture Society.2021; 34(3): 105. CrossRef
The Treatment of Subtrochanteric Fractures with Proximal Femoral Nail Antirotation
Chi Hyoung Pak, Sang Hong Lee, Sang Ho Ha, Gwang Chul Lee, Kyoung Chul Song
Journal of the Korean Fracture Society.2013; 26(4): 284. CrossRef

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Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA): Myung Sik Park, Young Jin Lim, Young Sin Kim, Kyu Hyung Kim, Hong Man Cho; J Korean Fract Soc 2009;22(2):91-97. Published online April 30, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.2.91

Abstract PDF

PURPOSE
To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA).
MATERIALS AND METHODS
We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20~88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12~18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up.
RESULTS
All fractures were united and the mean time to bone union was 15.7 (13~18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (+/-5.65~27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34~2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer.
CONCLUSION
We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.

Citations

Citations to this article as recorded by

Clinical and radiological outcome of the Chimaera short nailing system in inter- and subtrochanteric fractures
Aurélien Traverso, Trieu-Hoai-Nam Ngo, Guillem Fernandez Gil, Xavier Lannes, Sylvain Steinmetz, Kevin Moerenhout
Injury.2023; 54(3): 970. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation
Jong Won Kim, Hyun Soo Park, Young Soo Jang, Jae Hyuk Choi, Sung Ju Bae, Chan Il Bae
Journal of the Korean Fracture Society.2012; 25(4): 257. CrossRef
Cementless Bipolar Hemiarthroplasty Using a Rectangular Cross-section Stem for Type A2 or above Intertrochanteric Fractures
Bong-Ju Park, Hong-Man Cho, Cheol Park, Hwang-Se Bong
Hip & Pelvis.2012; 24(3): 222. CrossRef
Hip Arthroplasty for Failed Internal Fixation of Intertrochanteric Fractures
Ju-Oh Kim, Hong-Man Cho, Cheol Park, Ju-Hyun Sim
Hip & Pelvis.2012; 24(2): 94. CrossRef
Anatomical Measurement of Normal Korean Proximal Femur Using Plain Radiography: A Problem when using Proximal Femoral Nail Anti-rotation
Jong-Seok Park, Woo-Jong Kim, Jae-Wan Soh, Byung-Woong Jang, Tae-Heon Kim, You-Sung Suh
Hip & Pelvis.2011; 23(4): 303. CrossRef
The PFNA Nail for Pertrochanteric Fracture of the Femur without Fracture Table
Jeoung Ho Kim, Sang Hong Lee, Kwang Chul Lee, Sung Won Cho
Journal of the Korean Fracture Society.2011; 24(3): 217. CrossRef
PFNA and PFN in Intertrochanteric Fractures - Comparison Study of Sliding -
Suk Kyu Choo, Hyoung Keun Oh, Jun Young Choi
Hip & Pelvis.2010; 22(1): 79. CrossRef
Proximal Femoral Nail Antirotation versus Compression Hip Screw with Trochanter Stabilizing Plate for Unstable Intertrochanteric Hip Fractures
Jae-Young Rho, Sang-Bum Kim, Youn-Moo Heo, Seong-Jin Cho, Dong-Sik Chae, Woo-Suk Lee
Journal of the Korean Fracture Society.2010; 23(2): 161. CrossRef
Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate
Tae-Ho Kim, Jong-Oh Kim, Seung-Yup Lee, Geon-Ung Yun
Journal of the Korean Fracture Society.2010; 23(4): 353. CrossRef

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Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A: Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim; J Korean Fract Soc 2008;21(2):103-109. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.103

Abstract PDF

PURPOSE
To evaluate the results of fracture fixation between using Proximal Femoral Nail and using Proximal Femoral Nail A and to analyze the effectiveness of proximal femoral nail A.
MATERIALS AND METHODS
We reviewed 32 patients who suffered from intertrochanteric fracture in our hospital, which were 19 cases of PFN and 13 cases of PFNA. Retrospectively we evaluated mean operation time, amount of bleeding, beginning of ambulation, average union period, changes of neck shaft angle and complication on set of telephone interview and OPD. We also evaluated postoperative capability of function and mobility using 'Social function score' and 'Mobility score'.
RESULTS
PFNA showed shorter mean operation time, less bleeding, shorter average union period, earlier ambulation and less change of neck shaft angle than PFN. Although they didn't show statistical difference, postoperative capability of function and mobility showed statistical and mathematical difference on each group.
CONCLUSION
PFNA showed better results of postoperative function and mobility and less complications than PFN. So treatment using PFNA is better method than that of PFN.

Citations

Citations to this article as recorded by

Treatment of the Proximal Femoral Fracture Using the New Design Cephalomedullary Nail: Prospective Outcomes Study
Young Ho Roh, Joseph Rho, Kwang Woo Nam
Journal of the Korean Fracture Society.2019; 32(1): 35. CrossRef
Comparative Study of Intertrochanteric Fracture Treated with the Proximal Femoral Nail Anti-Rotation and the Third Generation of Gamma Nail
Jae-Cheon Sim, Tae-Ho Kim, Ki-Do Hong, Sung-Sik Ha, Jong-Seong Lee
Journal of the Korean Fracture Society.2013; 26(1): 37. CrossRef
Comparative Study of Proximal Femoral Nail Antirotation and Zimmer Natural Nail for the Treatment of Stable Intertrochanteric Fractures
Jee-Hoon Kim, Oog-Jin Shon
Journal of the Korean Fracture Society.2013; 26(4): 305. CrossRef
Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture
Kwang-Jun Oh, Sung-Tae Lee, Suk-Ha Lee, Jin-Ho Hwang, Min-Suk Kang
Journal of the Korean Fracture Society.2010; 23(1): 6. CrossRef
Treatment of the Unstable Intertrochanteric Fracture with Proximal Femoral Nail Antirotation: Comparison with Compression Hip Screw with Trochanteric Stabilizing Plate
Tae-Ho Kim, Jong-Oh Kim, Seung-Yup Lee, Geon-Ung Yun
Journal of the Korean Fracture Society.2010; 23(4): 353. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture
Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang
Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef

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The Result of Proximal Femoral Nailing (PFN(R)) for Unstable Femoral Peritrochanteric Fracture: Seung Yong Lee, In Heon Park, Kyung Won Song, Sung Il Shin, Jin Young Lee, Jeong Hun Cha; J Korean Soc Fract 2003;16(2):143-147. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.143

Abstract PDF

PURPOSE
We have used the proximal femoral nailing (PFN(R)) to evaluate the result of treatment for unstable femoral peritrochanteric fractures.
MATERIALS AND METHODS
From December 2000 to December 2001, 20 patients who had femoral peritrochanteric fracture were treated with proximal femoral nail (PFN(R)) in our hospital. The mean duration of follow-up was 16.8 months and average age was 58.7 years old. We evaluated the ambulation time, bone union time, neck-shaft angle, neck screw sliding by follow-up radiography, and studied the intra-operative and post-operative complication.
RESULTS
The average ambulation time was 3.8 days, the mean bone union time was 20.9 weeks, the mean neck shaft angle was 130.2 degree at post-operative time and 128.8 degree at last follow-up time, and the average neck screw sliding distance was 4.1 mm. The intra-operative complication was rotation of proximal fracture fragment in 1 case and displacement of femoral greater trochanter in 2 cases at proximal reaming, and displacement of proximal fracture fragment in 1 case at femoral stem insertion. The post-operative complication was coxa vara deformity in 2 cases and superficial wound infection in 1 case.
CONCLUSION
We have conclude that the proximal femoral nail (PFN(R)) could appropriately treat the unstable femoral peritrochanteric fracture and we obtained satisfactory results.

Citations

Citations to this article as recorded by

Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh
Hip & Pelvis.2013; 25(1): 51. CrossRef
Operative Treatment with ITST in Femur Trochanteric Fracture
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2008; 21(4): 274. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef

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The proximal femoral nail for intertrochanteric fracture of the femur: Young Wan Moon, Dong Hyun Suh, Shin Taeg Kang, Duck Joo Kwon, Yong Nam Ji, Kee Byoung Lee; J Korean Soc Fract 2003;16(1):29-36. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.29

Abstract PDF

PURPOSE
To evaluate the treatment results of geriatric intertrochanteric fractures using a proximal femoral nail.
MATERIALS AND METHODS
From April 2001 to Feburary 2002, 71 cases of the intertrochanteric fractures were treated with proximal femoral nail(PFN), more often in communited fractures involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, operation time, blood loss and complications.
RESULTS
The average age was 77.5 years old, the mean duration of follow-up was 9 months and the mean duration of bone union was 13.8 weeks. The average neck-shaft angle on immediate postop. x-ray was 131.9 +/-5.21 degrees and 129.9 +/-6.04 degrees at last follow up and the average lag screw sliding was 4.21 +/-4.13 mm. The average operation time was 61 minute and blood loss was 0.67 pints(134cc). Intraoperative complications were inadequate reduction in one case, difficulty in distal transfixing in one case and drill bit failure in one case and postoperative complications were loss of neck-shaft angle (more than 5 degree) in 12 cases, femur neck fracture in 2 cases and intraarticular cutting out of femur neck screw in one case.
CONCLUSIONS
The use of the proximal femoral nail could be appropriate for the fixation of communited or reverse oblique intertrochanteric fracture in elderly, osteoporotic patients for early ambulation, preventing shortening and rotation deformity, and reducing operation time and blood loss.

Citations

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Treatment of Intertrochanteric Fractures Using the Compression Hip Nail
Je-Min Yi, Kye Young Han, Keun Woo Kim, Chang Hyun Ryu
Hip & Pelvis.2014; 26(3): 166. CrossRef
Treatment of Intertrochanteric Fractures Using Targon Proximal Femoral Nails
Il Ho Park, Jong Kyoung Won, Kye Young Han
Hip & Pelvis.2012; 24(2): 117. CrossRef
Proximal Femoral Nail Antirotation and Proximal Femoral Nail in Intertrochanteric Fractures
Sung Soo Kim, Chul Hong Kim, Jin Hun Kang, Dong Hoon Han, Yong Seung O
Journal of the Korean Orthopaedic Association.2011; 46(5): 392. CrossRef
Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture
Yerl-Bo Sung, Sung-Il Jo
The Journal of the Korean Hip Society.2011; 23(1): 39. CrossRef
Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture
Jong Min Lim, Jeung Il Kim, Jong Seok Oh, Kuen Tak Suh, Jae Min Ahn, Dong Joon Kang
Journal of the Korean Fracture Society.2010; 23(4): 360. CrossRef
Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)
Myung-Sik Park, Young-Jin Lim, Young-Sin Kim, Kyu-Hyung Kim, Hong-Man Cho
Journal of the Korean Fracture Society.2009; 22(2): 91. CrossRef
Treatment of Intertrochanteric Fracture: Comparison of Proximal Femoral Nail and Proximal Femoral Nail A
Jung Ho Park, Jong Woong Park, Joon Ho Wang, Jae Wook Lee, Jung Il Lee, Jae Gyoon Kim
Journal of the Korean Fracture Society.2008; 21(2): 103. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef

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