Long nail achei ve proper aigl nment of the inuj red lmi b pori r to reamni g. Cai 1department of orthopedic surgery, shanghai tenth peoples hospital, tongji university, school of medicine, shanghai, china. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients j. However, the use of the nail is technically ambitious and is accompanied by some risks of error, which can lead to failure of the osteosynthesis. The ufn is preferably used with the unreamed technique while, since it is cannulated, the cfn is primarily used with the reamed technique using a guide wire. Safe, rapid, and effortless femoral nail removal using a. A new design for the treatment of unstable proximal femoral fractures. Apr 15, 2004 osteosynthesis with the proximal femoral nail pfn features the advantages of high rotational stability of the headneck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. Femoral shaft fracture intramedullary nailing femur fracture. The treatment of stable and unstable proximal femoral fractures with a new trochanteric nail. With a growing aging population, the incidence of intertrochanteric fractures is rising. Retograde nail antegrade femoral nail distal femoral nail supra condylar nail 6. Then you can start reading kindle books on your smartphone, tablet, or computer no kindle device required.
This serves not only to reduce the fracture, but also permits free access to the greater trochanter. The current status of prophylactic femoral intramedullary. Complex proximal femoral fractures in the elderly managed by. Intramedullary nails used for fixation of femoral fractures may require removal for a variety of reasons. Pdf short proximal femoral nail fixation for trochanteric. At postmortem, bony metastases have been found in 70% of patients dying from breast and prostate cancer.
These devices have been found to suffer from cutout, implant breakage, femoral shaft fractures, and subsequent loss of reduction in clinical practice domingo et al. Femoral universal femoral universal nailing system options. We made a retrospective study of 65 patients with femoral metastases treated with intramedullary nails between 1995 and 2011 at the department of traumatology in hospital clinico san carlos in madrid. A wide variety of proximal femur nail options are available to you. In this presentation intramedullary nailing of the femur will be demonstrated using the expert a2fn. With the ball tip end resting at the desired level, distal end of nail the telescoping tube is extended to the end of the guide wire.
Oct 15, 20 we made a retrospective study of 65 patients with femoral metastases treated with intramedullary nails between 1995 and 2011 at the department of traumatology in hospital clinico san carlos in madrid. Enter your mobile number or email address below and well send you a link to download the free kindle app. Retrograde femoral nailing has expanded the use of intramedullary nails 1, 2. The short proximal femoral nail is a superior implant for stable and unstable intertrochanteric. Nail sizing using telescoping gauge the telescoping nail measuring gauge is placed over the 98cm ball tip guide wire until it rests on the trochanter figure 11. Proximal femoral nails antirotation, gamma nails, and dynamic. Phoenix antegrade femoral nail system featuring corelock technology 20 biomet orthopedics form no. Osteosynthesis with the proximal femoral nail pfn features the advantages of high rotational stability of the headneck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. Your child will be able to move his hip, knee and ankle on the operated side. Standard pfn and long pfn simple, reliable, versatile.
Ufn unreamed femoral nail cfn cannulated femoral nail. Trigen im nail system femoral tibial intertan short and long lengths metanail retrograde femoral fan femoral antegrade nail standard and recon locking options tan metanail tibial trochanteric antegrade nail standard and recon locking options. Intramedullary nailing using the expert antegrade femoral. Solid and cannulated nails technique guide synthes paperback 1996. Common 5mm cortical screws simplify the surgical procedure and promote a minimally invasive approach. Unfollow femoral nail to stop getting updates on your ebay feed. Femoral shaft fractures proximal or midshaft femoral nonunions and malunions pathologic fractures in osteoporotic bone of the diaphyseal area revision procedures retrograde locking option antegrade locking options the universal femoral nail hole configurations provide a number. It has been estimated that intertrochanteric fractures occur in more than 200,000 people each year in the united states, with reported mortality rates ranging from 15% to 30% there is a considerable debate regarding which is the optimal implant for fixing intertrochanteric fractures. Prep the hip limb free, circumferentially from the hemi pelvis to the toes, to ensure access to the lesser trochanter. The patient is positioned supine on the traction table. Treatment of trochanteric fractures with proximal femoral nail. Treatment of the proximal femoral fractures with proximal femoral nail antirotation pfna.
Innovative technique article pdf available in open journal of orthopedics 0806. Proximal femoral nail in reverse trochanteric femoral fractures. The trigen tan and fan intramedullary nails are indicated for. Determine nail insertion point and insert guide wire in the ap view, the nail insertion point is normally found on the tip or slightly lateral to the tip of the greater trochanter in the curved extension of the medullary cavity. Jun 14, 20 this is an example of a surgery to fix a femur thigh bone fracture utilizing an intramedullary nail. This study aims to evaluate use of the russelltaylor reconstruction nail rtrn in this group with regard to mortality risk, complication rates and final outcome. Zimmer natural nail system retrograde femoral nail surgical. Some recommend that all such nails be removed after fracture healing,1,2 whereas others prefer to remove only those that cause symptoms. Unstable proximal femoral fractures and pathological lesions involving the trochanteric region in the elderly comprise an increasing workload for the trauma surgeon as the ageing population increases. Orthopaedic advances motorized intramedullary nail for. Due to the prevalence of cancer, bone metastasis and the associated management represents a huge. There were 21 prophylactic and 44 therapeutic nails with a mean followup of 15 months range 327. Access is improved by inclining the trunk towards the uninjured side by about 25. The procedure is performed using a lateral trochanteric entry point to facilitate a simplified procedure, and reduces the danger to blood.
Sixteen patients had proximal femoral fractures and 23 patients had femoral metastases. Failure of intramedullary femoral nail with segmental. Femoral shaft fracture intramedullary nailing femur. The procedure involves inserting a metal rod called an intramedullary nail, or femoral nail, into the femur and positioning it so that it runs vertically along the length of the shaft. Randomised comparison of the gamma nail and the pfn.
Nail combines the principles of a compression hip screw with. A lateral longitudinal femoral osteotomy was used for the resection of the distorted nail. The joints will remain flexible and muscle strength. Femoral neck fracture after removal of the standard gamma interlocking nail. As the nail passes through the middle of the bone, it serves to. Proximal femoral nail versus dynamic hip screw fixation.
To estimate the nail diameter, place the template on the lateral xray of the uninjured femur and measure the dia. Operative treatment fixedangle nailplate devices the first successful implants were fixedangle nailplate devices e. Reason and treatment of failure of proximal femoral nail. Solid and cannulated nails technique guide synthes synthes on. Finite element analysis of proximal femur nail for. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. The unreamed femoral nail ufn and the cannulated femoral nail cfn are used to stabilize diaphyseal and metaphyseal fractures of the femur. Proximal femoral nail antirotation versus gamma3 nail for. Apr 18, 2020 femoral nailing is a surgical technique used to treat a fractured or broken femur, or thighbone. We propose to improve the use of proximal femoral nail antirotation in korea by reporting anatomical measurements of the normal korean. The rod is fixed by screws at both ends and will keep the bone stable in order to ensure proper healing.
If advancement of the nail is difficult remove the nail and ream up another. Proximal femoral nail pfn are used to fix pertrochanteric, intertrochanteric, high subtrochanteric and transcervical fractures of the femur. This material is intended for the sole use and benefit of the biomet sales force and health care. Pitfalls and complications in the use of the proximal femoral. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. Canal preparation nail selection figure 10 figure 11 surgical technique proximal end color pink darkgolden nail type left right neogen femoral nail. Treatment of the intertrochanteric femoral fracture with proximal femoral nail. Surgical technique for the afn antegrade femoral nail afn surgical technique 11 p a determine nail insertion point and insert guide wire in the ap view, the nail insertion point is normally found on the tip or slightly lateral to the tip of the greater trochanter in the curved extension of the medullary cavity. Orthopaedic advances motorized intramedullary nail for management of limblength discrepancy and deformity abstract distraction osteogenesis has been used for more than 50 years to address limblength discrepancy and deformity. Intramedullary nailing for femur fracture management. Volume 43, supplement 2, december 2012, pages s47s54. Proximal femoral nails antirotation, gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur. Using controlled blows with the mallet, drive the nail into the distal femur.
The centronail titanium universal femoral nailing system. Lavini f, renzi brivio l, aulisa r, cherubino f, di seglio pl, galante n, leonardi w, manca m. Pdf the treatment of trochanteric femoral fracture with. Pedinail intramedullary nail the pedinail intramedullary nail is anatomically designed to meet the unique needs of pediatric and adolescent patients, and is available in diameters of 7, 8, 9, and 10mm with lengths ranging from 2038cm. Short proximal femoral nail fixation for trochanteric fractures. Kukla c, pichl w, prokesch r, jacyniak w, heinze g, gatterer r, et al. The remotecontrolled magnetic intramedullary nail is a telescopic implant that contains a magnet that turns a gear box to induce controlled elongation of the nail. Femoral lengthening over nail video journal of orthopaedics. Complicated multiple trauma injuries, associated pelvic and acetabular frac tures. Utilizing the trigen sureshot distal targeting system. Plan the diameter of the nail on the basis of a measurement of the medullary canal on a calibrated radiograph.
Be sure that the nail slides free over the guide wire to prevent advancement of the guide wire distally. This is an example of a surgery to fix a femur thigh bone fracture utilizing an intramedullary nail. This is a minimally invasive way of fixing this surgical problem and allows for immediate range of motion and full weightbearing. Benefits of early intramedullary nailing in femoral metastases. The femur was reconstructed with a new nail, and the fixation. Feb 04, 2017 in this presentation intramedullary nailing of the femur will be demonstrated using the expert a2fn. Ream as necessary to enlarge the diaphysis to accept the selected nail.
Proximal femoral nail standard pfn and long pfn 12 1. Trochanteric buttress plate combined with proximal femoral nail for unstable intertrochanteric fractures. Phoenix antegrade femoral nail system featuring corelock. Pdf trochanteric buttress plate combined with proximal. Femoral universal femoral universal nailing system. Besides the t2 femoral nail with a 3m radius of curvature, stryker offers also a 1. Affixus hip fracture nail surgical technique zimmer biomet. A cadaveric study to determine factors influencing the biomechanical properties of the proximal femur. Pdf treatment of the intertrochanteric femoral fracture. Short nail confirm that the femoral diaphysis is wide enough and long enough to allow the selected nail diameter to pass.
The zimmer natural nail system is a system of intramedullary im nails, screws, instruments and other associated implants that are designed to provide stable internal fixation for fractured long bones. A secondary highvelocity trauma to a previously stabilized femoral fracture with intramedullary nailing is rare. Complex proximal femoral fractures in the elderly managed. Proximal femoral nails antirotation, gamma nails, and. Dec 01, 2016 the most common site for cancer to spread is bone. In this paper, we present the management of a 40yearold man presented with a bent intramedullary nail due to secondary trauma. These techniques of distraction osteogenesis have two distinct phases of. All randomized controlled trials comparing proximal femoral nail and dynamic. Medial migration into the pelvis of the femoral head lag screw, similar to the reverse zeffect, may occur with hip nails comprising a single femoral head lag screw. Pdf treatment of the proximal femoral fractures with. The aoasif proximal femoral nail antirotation pfna. W grechenig, r szyszkowitzthe proximal femoral nail pfn a minimal invasive treatment of unstable proximal femoral fractures. If the nail cannot be inserted, select a smaller size nail diameter. Current techniques of femoral lengthening rely on gradual distraction with use of external fixation to form new bone in the distraction gap.
Mechanical failures after fixation with proximal femoral. In most cases, neither a cast nor brace will be required postsurgery. Since its introduction as a treatment for femoral and tibial shaft fractures, indications for use of intramedullary. The pedinail intramedullary nail is anatomically designed to meet the unique needs of pediatric and adolescent patients, and is available in diameters of 7, 8, 9, and 10mm with lengths ranging from 2038cm. For the freehand distal locking screws, follow the proce dure described in section retrograde approach free hand locking, steps 2 to 6.
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