Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip-Blade vs screw

Lenich, Andreas and Vester, Helen and Nerlich, Michael and Mayr, Edgar and Stoeckle, Ulrich and Fuechtmeier, Bernd (2010) Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip-Blade vs screw. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 41 (12). pp. 1292-1296. ISSN 0020-1383, 1879-0267

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Abstract

With industrial societies getting older the incidence of femoral fractures is increasing. Complication rates up to 20% have led to a continuous improvement of intramedullar nailing systems and the third generation of implants is in clinical application. They seem superior to the second generation. But as clinical data is still fragmentary, we wanted to compare a second generation implant, the Proximal Femur Nail with three devices of the third generation: the Gleitnagel, Trochanter Fixation Nail and the Proximal Femur Nail Antirotation with a clinical study. We analysed whether fracture reduction and implant position could possibly be indicators for implant complications. Patients with a trochanteric fracture type A1-A3 (AO/ASIF classification) admitted at the department of traumatology Augsburg were enrolled. Postoperative X-rays were analysed in the matter of fracture reduction for the fracture gap, the Garden Alignment Index and for the matter of implant position in the femur head with the cleaveland zones and the Tip Apex Distance. 322 patients were enrolled. Most frequent was the A2 (n = 240) and the A3 type of fracture (n = 80) followed by A1 (n = 29). Time to hospital discharge was 17 days (9/25), 12 patients died (3.2%). The complication rate (cutting out) in the third generation was lower (2.5-7%) than in the second generation (14%). The postoperative range of mobilisation compared to the old social status was in the groups with 34% similar after 3 months. The third generation nails are safe and reliable implants. Compared with second generation devices, fewer complications are observed. A correlation might be seen in the postoperative X-rays between the fracture reduction or implant position and implant related mechanical complications (cutting out). (C) 2010 Elsevier Ltd. All rights reserved.

Item Type: Article
Uncontrolled Keywords: PROXIMAL FEMUR; INTERNAL-FIXATION; FEMORAL FRACTURES; MORTALITY; COMPLICATIONS; NAIL; EXTRAMEDULLARY; ARTHROPLASTY; SURGERY; PFN; Trochanteric fracture; Intramedullary nail; Tip Apex Distance; Cleaveland zones; Mechanical complication; Cutting out
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Unfallchirurgie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 Jul 2020 07:49
Last Modified: 06 Jul 2020 07:49
URI: https://pred.uni-regensburg.de/id/eprint/23796

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