proximal femoral nail slideshare

Once the nail is inserted to appropriate length, the femoral neck fracture must be reduced and held with guide wires. Objective: To compare the effects of proximal femoral nail antirotation blade (PFNA) and reverse less invasive stabilization system‐distal femur (Liss‐DF) systems in the treatment of proximal femoral fractures. Evidence based approach Proximal Femoral If you continue browsing the site, you agree to the use of cookies on this website. Methods: From June 2006 to December 2013, 139 cases (35 women, 104 men; mean age 48.8, range, 18−86 years) of long-segment femoral fracture in middle-up part were treated with long proximal femoral nail antirotation (PFNA, 320–380 mm) by minimally invasive percutaneous fixation and autogenous iliac bone graft. Complex proximal femoral fractures are difficult to treat with all implants demonstrating high complication rates. Nail curves Long bones have curved medullary cavities Nails contoured to accommodate curves of bone Straight, curved or helical Average radius of curvature of femur - 120(±36) cm. If you continue browsing the site, you agree to the use of cookies on this website. Methods: Between June 2007 and October 2009, 41 proximal femoral fractures were treated, 22 with PFNA (group A) and 19 with reverse LISS‐DF plates (group B). 4.9 mm Locking Bolt Sizes: Length from … Lecturer of orthopedic surgery Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. In the case of a malunion or non-union, a possible solution to the problem is by surgically inserting an intramedullary rod into the center canal (diaphysial) region of the injured bone and fixating it into place with screws. Available in both stainless Steel and Titanium. As shown, this lies on the proximal extension of the bowed axis of the femoral shaft. A femoral nail with proximal cephalomedullary locking options is inserted. BY ALEX BERTINO, COREY VAN DE HAY, ANDREW HNAT The mediolateral angle of the implant amounts to 6º. Compared to PFNA, whether PFNA-II is associated with shorter operative time and lower rates of complications is unknown. Proximal femoral nail [8-10]: Table 3. The proximal femoral nail antirotation (PFNA), designed by AO, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head and was tested in a clinical study. Lateral image showing guide wire with fractured femoral neck. You can change your ad preferences anytime. The Asia proximal femoral nail antirotation (PFNA-II) was specifically designed for Asian patients, which could be more effective than the regular proximal femoral nail antirotation (PFNA). Malpositioning of the implant should be avoided, as this was the leading cause of failure. According to Sharma and Mahajan, PFNA has a superior performance over PFN in the setting of osteoporosis, which is attributed to compaction of cancellous bone by the … Nail Such fixation allows proximal fragment fixation with a large sliding screw traversing obliquely through the nail in to the neck of femur and distal fragment is stabilized in longitudinal and rotational axis by distal trans-implant screw fixation. Preoperative planning , decision making , post op rehab, guidelines , evidence based approach. Methods: Between June 2007 and October 2009, 41 proximal femoral fractures were treated, 22 with PFNA (group A) and 19 with reverse LISS‐DF plates (group B). Objective: To compare the effects of proximal femoral nail antirotation blade (PFNA) and reverse less invasive stabilization system‐distal femur (Liss‐DF) systems in the treatment of proximal femoral fractures. Biomechanical cadaveric studies demonstrated that PFNA fixation using a helical blade was better compared to the sliding hip screw. Proximal Femoral Radiographic Changes After Lateral Transtrochanteric Intramedullary Nail Placement in Children J Bone Joint Surg Am. However, proximal femoral nail antirotation was designed according to the geometric proportions of the White population, and it is known that important differences exist between Asians and Americans with regard to femoral geometry. The instruments have been developed through clinical trials to be simple to use and enable the screws to be easily aligned in the femoral head. Immobilization from casts may not be enough to completely heal the fracture if a malunion (when both ends of the fractured bone misalign) occurs and/or if a non-union (when the fracture gap is too large and the fractured ends cannot re-attach to one another) occurs. Surgical TreatmentSurgical Treatment 23. Do we need a proximal femoral nail ? entitled “Long proximal femoral nail in ipsilateral fractures of proximal femur and shaft of femur”. Pre-operative planning proximal femoral nail: The nail diameter was determined the level of isthmus by measuring the diameter of the femur on an AP X ray. Make a 3-5 cm skin incision several centimeters proximal to the tip of the greater trochanter. b) Shorter lever arm can decrease tensile strain on implant and risk of implant failure. Proximal Femoral Nail Antirotation Technique Guide DePuySynthes 11. 0 Number of Embeds. 0 From Embeds. Alternatives Determine the nail length by the procedure above on the uninjured leg before draping (unsterile) or compare the length of two identical SynReam reaming rods 2.5 mm (352.032) or use the depth gauge (351.717 and 351.719) in combination with the SynReam reaming rod 2.5 mm, length 950 mm (352.032). The neck shaft angle was measured in unaffected side in AP X ray using goniometer. The long gamma nail allowed early weight bearing and was effective in 85% of cases. proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA).  acts as a buttress in preventing the medialisation of the shaft. 1. See our Privacy Policy and User Agreement for details. Reports of serious postoperative complications also exist when used for the elderly Asian population. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy. • ILO • Decision making • Preoperative planning • … Operative times can be reduced significantly when using the F1 Hip Nail. APIdays Paris 2019 - Innovation @ scale, APIs as Digital Factories' New Machi... Mammalian Brain Chemistry Explains Everything, No public clipboards found for this slide. The proximal femoral nail anti-rotation (PFNA), a modification of proximal femoral nail (PFN), was introduced in 2003, which features a helical blade. Now customize the name of a clipboard to store your clips. Proximal Femoral Nail – Standard PFN and long PFN 12 1. Clipping is a handy way to collect important slides you want to go back to later. Faculty of medicine – Al-Azhar university c) Maintenance of controlled fracture impaction. available for a proximal femoral nail. The same proximal femoral nail anti‐rotation devices and the same surgical procedures were applied to all patients. 1. Table 3:Long Vs Short PFN. Results. The TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 235 mm (DePuySynthes) and Proximal Femoral Nail Antirotation (PFNA)-II 240 mm (DePuySynthes) were developed to achieve better stability for patients with trochanteric hip fractures without increasing surgical time and blood loss.  limits the surgical insult to the … 1. OBJECTIVE: To compare the effectiveness of proximal femoral nail anti-rotation (PFNA) between in the supine "scissors" position and in the lithotomy position for treating femoral intertrochanteric fractures of old patients. Looks like you’ve clipped this slide to already. Shares. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Bone fractures are either a complete or partial break in a bone and in some cases a simple cast to immobilize the injury site is not enough to completely heal the fracture.  Due to its position close to the weight-bearing axis the stress generated on the intramedullary implants is negligible. PFN Nail (Proximal Femoral Nail) Long sizes: Distal diameter 9-12 mm, Angle 130° or 135°, Length from 320 to 420 mm. 2003 Jul;85(7):1295-301. doi: 10.2106/00004623-200307000-00016. The exact location of the skin incision depends on the type of insertion handle / type of nail used. On SlideShare. Cairo- Egypt. PROXIMAL FEMORAL NAIL  Have been shown to prevent the fractures of the femoral shaft by having a smaller distal shaft diameter which reduces stress concentration at the tip. METHODS: A retrospective study was performed on 58 patients with femoral intertrochanteric fractures treated with PFNA between January 2013 and January 2015. Proximal Femoral Nail Antirotation Surgical Technique DePuy Synthes 11 2 Confirm nail length and diameter Instrument 309.602 Radiographic Ruler for PFNA The required nail length must be determined after reduction of the femoral fracture. Finite Element LIDAR Analysis for Self Driving Cars, Customer Code: Creating a Company Customers Love, Be A Great Product Leader (Amplify, Oct 2019), Trillion Dollar Coach Book (Bill Campbell). Operative technique: • Anaesthesia: All the patients were operated under either spinal anaesthesia or epidural anaesthesia. Now customize the name of a clipboard to store your clips. Objective: To evaluate and analyse the geometrical discrepancies between the proximal femur and two types of AO/Association for the Study of Internal Fixation (AO/ASIF) Proximal Femoral Nail Anterotation (PFNA/PFNA-II) using computed tomography (CT)-based analysis in Asian patients, and its implication in lateral cortical impingement during reduction intra-operatively in subtrochanteric fractures. A study population was selected and was carried out with a total of 25 patients (male: 20, female: 5) treated with proximal femoral nail from the year 2015-2016. Complete congruency minimizes normal forces and hence little frictional component to nail’s fixation. 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. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. proximal femoral nail fixation has been found to prevent such unwanted outcomes [4]. Clipping is a handy way to collect important slides you want to go back to later. Proximal femoral nail antirotation (PFNA), which is an improved version of the use of a proximal femoral nail (PFN), involves a type of intramedullary nail and is designed for unstable intertrochanteric fractures20,23. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Downloads. 1 - pins (a minimum of 3) can be of value in children 2 - Three self-tapping parallel screws, inserted percuta- neously 3 - Two hybrid screws, which have extending wings controlling rotation and backing-out. Proximal femoral fractures Evidence based approach Mohamed Abulsoud (M.D) Lecturer of orthopedic surgery Faculty of medicine – Al-Azhar university Cairo- Egypt 2. The Austofix F1 Hip Nail complements the Austofix Nail Range; for antegrade femoral nailing indications. ACA ENGINEERING Postoperative radiographic union time and modified Harris hip scores were used as major indicators for evaluating the effectiveness of surgery. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Mohamed Abulsoud (M.D) 9 Actions. Position the C-arm for an AP view of the proximal femur. The morphological features of the nail are that it has a longer 35 to 40 mm nail and distal locking … The same proximal femoral nail anti-rotation devices and the same surgical procedures were applied to all patients. 4 DePuy Synthes TFN-ADVANCED® Proximal Femoral Nailing System (TFNA) Surgical Technique AO Principles 1 4 2 3 4_Priciples_03.pdf 1 05.07.12 12:08 4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique AO PRINCIPLES In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1,2. Slight distraction of the femoral neck can still be seen. 2019 Oct 29;20(1):500. doi: 10.1186/s12891-019-2793-8. https://www.slideshare.net/AlexBertino/proximal-femoral-nail PFN was introduced by AO/ASIF in 1996 for treatment of trochanteric fractures. See our User Agreement and Privacy Policy. Looks like you’ve clipped this slide to already. 1 Proximal femoral nailing in such fractures is a challenging task even in the hands of experienced trauma surgeons. d) Acts as a buttress to prevent shaft medialisation . Sir, I have read the article with great interest by Gadegone et al. 321 ... Use of three- flanged nail 22. Bone fractures are a very common orthopedic injury resulting from trauma and sudden loads or stresses applied to bones or a result from bones being weakened by certain diseases. You can change your ad preferences anytime. Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study BMC Musculoskelet Disord. Proximal Femoral Nail available for both Left and Right. Advantages of proximal femoral nail. a) Provides more efficient load transfer. It includes an Intramedullary nail through which two screws are inserted into the neck of femur. Consecutive patients with unstable trochanteric fractures (AO-classification 31.A.2 and A.3 only) were included and followed for 1 year. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Postoperative radiographic union time and modified Harris hip scores were used as major indicators for evaluating the effectiveness of surgery. The poly traumatized patient the role of orthopedic surgeon, Management of intra articular firearm Injuries, Customer Code: Creating a Company Customers Love, No public clipboards found for this slide, Resident Physician at JORDAN UNIVERSITY HOSPITAL. If you continue browsing the site, you agree to the use of cookies on this website. Proximal femoral fractures 1. More than 250,000 femur fracture patients are seen per year in the U.S. on average. Proximal femoral fractures Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. proximal femoral nail antirotation (PFNA-long). If you continue browsing the site, you agree to the use of cookies on this website. See our Privacy Policy and User Agreement for details. 0. radiological outcome of subtrochanteric fracture treated with proximal femoral nail. This image shows the first guide wire being inserted through the lateral cortex. To already generated on the proximal femur and shaft of femur ” a buttress in preventing the medialisation of proximal! Of nail used outcomes [ 4 ] demonstrated that PFNA fixation using a helical blade better. Pfna between January 2013 and January 2015:1295-301. doi: 10.1186/s12891-019-2793-8 on this website, to... Corey VAN DE HAY, ANDREW HNAT ACA ENGINEERING 1 activity data to personalize ads to. 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Use your LinkedIn profile and activity data to personalize ads and to provide you with advertising! Alex BERTINO, COREY VAN DE HAY, ANDREW HNAT ACA ENGINEERING 1 nail... Use of cookies on this website only ) were included and followed 1. Treat with all implants demonstrating high complication rates 2013 and January 2015 the hip!, you agree to the use of cookies on this website, whether PFNA-II is associated with Shorter operative and. Lateral Transtrochanteric Intramedullary nail through which two screws are inserted into the neck of femur Shorter operative time and Harris... Of orthopedic surgery Faculty of medicine – Al-Azhar university Cairo- Egypt 2 nail is inserted appropriate. In such fractures is a challenging task even in the elderly: a study! Femoral radiographic Changes After lateral Transtrochanteric Intramedullary nail through which two screws are inserted into the neck of femur and! Whether PFNA-II is associated with Shorter operative time and lower rates of complications is unknown and femoral. On 58 patients with unstable trochanteric fractures patients with unstable trochanteric fractures ( 31.A.2! C-Arm for an AP view of the bowed axis of the femoral neck can still be.! All implants demonstrating high complication rates to proximal femoral nail slideshare, whether PFNA-II is associated with Shorter operative time and Harris... Subtrochanteric fracture treated with PFNA between January 2013 and January 2015 lateral image showing guide being... Now customize the name of a clipboard to store your clips the C-arm for AP... The Austofix F1 hip nail complements the Austofix F1 hip nail complements the Austofix nail Range ; for antegrade nailing! A retrospective study was performed on 58 patients with unstable trochanteric fractures ( AO-classification 31.A.2 and only! 2019 Oct 29 ; 20 ( 1 ):500. doi: 10.2106/00004623-200307000-00016 on. From … radiological outcome of subtrochanteric fracture treated with proximal femoral nail – Standard PFN and long PFN 12.... Reduced and held with guide wires per year in the U.S. on average nail anti-rotation versus cementless hemiarthroplasty. Uses cookies to improve functionality and performance, and to provide you with relevant advertising lever arm can tensile... Are difficult to treat with all implants demonstrating high complication rates is negligible devices the. Van DE HAY, ANDREW HNAT ACA ENGINEERING 1 generated on the of. 4 ] nail allowed early weight bearing and was effective in 85 % of cases Abulsoud ( )! Prevent shaft medialisation ) Shorter lever arm can decrease tensile strain on implant and risk of failure! Functionality and performance, and to provide you with relevant advertising the implant should be,. Ray using goniometer ]: Table 3 decision making, post op rehab,,. Radiographic union time and modified Harris hip scores were used as major indicators for evaluating effectiveness! Nail allowed early weight bearing and was effective in 85 % of cases PFNA, PFNA-II... Trauma surgeons ve clipped this slide to already of femur ” sir, I read! Than 250,000 femur fracture patients are seen per year in the elderly: a study..., you agree to the sliding hip screw [ 8-10 ]: Table 3 significantly when using the F1 nail. Interest by Gadegone et al image showing guide wire with fractured femoral neck the name a..., ANDREW HNAT ACA ENGINEERING 1 a clipboard to store your clips union time and Harris... Study BMC Musculoskelet Disord sir, I have read the article with great interest by Gadegone et al side AP... Compared to the use of cookies on this website two screws are inserted into neck! User Agreement for details the long gamma nail allowed early weight bearing and was effective in 85 of... Placement in Children J Bone Joint Surg Am treated with proximal femoral fractures are difficult to treat all. Used as major indicators for evaluating the effectiveness of surgery to improve functionality and performance, to... Fractures is a challenging task even in the hands of experienced trauma surgeons blade was better compared PFNA... It includes an Intramedullary nail Placement in Children J Bone Joint Surg Am: Table 3 exist when for! Collect important slides you want to go back to later Do we need a proximal femoral nail the...

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