Proximal Femoral 1 Proximal femoral nailing in such fractures is a challenging task even in the hands of experienced trauma surgeons. Postoperative radiographic union time and modified Harris hip scores were used as major indicators for evaluating the effectiveness of surgery. 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. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. 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. Nail Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 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). Clipping is a handy way to collect important slides you want to go back to later. 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. 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. Reports of serious postoperative complications also exist when used for the elderly Asian population. 0. 0 Number of Embeds. 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). A femoral nail with proximal cephalomedullary locking options is inserted. 1. Results. The proximal femoral nail anti-rotation (PFNA), a modification of proximal femoral nail (PFN), was introduced in 2003, which features a helical blade. If you continue browsing the site, you agree to the use of cookies on this website. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Make a 3-5 cm skin incision several centimeters proximal to the tip of the greater trochanter. Operative times can be reduced significantly when using the F1 Hip Nail. 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 (PFN) and proximal femoral nail antirotation (PFNA). 1. More than 250,000 femur fracture patients are seen per year in the U.S. on average. 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. 2019 Oct 29;20(1):500. doi: 10.1186/s12891-019-2793-8. 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. The long gamma nail allowed early weight bearing and was effective in 85% of cases. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. This image shows the first guide wire being inserted through the lateral cortex. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 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. Malpositioning of the implant should be avoided, as this was the leading cause of failure. Shares. Proximal femoral fractures Evidence based approach Mohamed Abulsoud (M.D) Lecturer of orthopedic surgery Faculty of medicine – Al-Azhar university Cairo- Egypt 2. Looks like you’ve clipped this slide to already. Now customize the name of a clipboard to store your clips. 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. 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). Available in both stainless Steel and Titanium. APIdays Paris 2019 - Innovation @ scale, APIs as Digital Factories' New Machi... Mammalian Brain Chemistry Explains Everything, No public clipboards found for this slide. 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. Lecturer of orthopedic surgery • ILO • Decision making • Preoperative planning • … Slight distraction of the femoral neck can still be seen. Proximal femoral fractures The same proximal femoral nail anti-rotation devices and the same surgical procedures were applied to all patients. 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. Table 3:Long Vs Short PFN. 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.  limits the surgical insult to the … Downloads.  acts as a buttress in preventing the medialisation of the shaft. Complete congruency minimizes normal forces and hence little frictional component to nail’s fixation. b) Shorter lever arm can decrease tensile strain on implant and risk of implant failure. 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. METHODS: A retrospective study was performed on 58 patients with femoral intertrochanteric fractures treated with PFNA between January 2013 and January 2015. The Austofix F1 Hip Nail complements the Austofix Nail Range; for antegrade femoral nailing indications. Do we need a proximal femoral nail ? Preoperative planning , decision making , post op rehab, guidelines , evidence based approach. 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 … Once the nail is inserted to appropriate length, the femoral neck fracture must be reduced and held with guide wires. 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. Now customize the name of a clipboard to store your clips. Proximal femoral nail [8-10]: Table 3. As shown, this lies on the proximal extension of the bowed axis of the femoral shaft. 1. BY ALEX BERTINO, COREY VAN DE HAY, ANDREW HNAT Proximal femoral fractures 1. Proximal Femoral Nail – Standard PFN and long PFN 12 1. entitled “Long proximal femoral nail in ipsilateral fractures of proximal femur and shaft of femur”. If you continue browsing the site, you agree to the use of cookies on this website. Evidence based approach 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. Looks like you’ve clipped this slide to already. 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. If you continue browsing the site, you agree to the use of cookies on this website. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. It includes an Intramedullary nail through which two screws are inserted into the neck of femur. 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. 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). Performance, and to provide you with relevant advertising outcomes [ 4 ] the hands of experienced surgeons... Post op rehab, guidelines, Evidence based approach Mohamed Abulsoud ( M.D ) Lecturer of orthopedic Faculty! Bearing and was effective in 85 % of cases associated with Shorter time... Strain on implant and risk of implant failure Bolt Sizes: Length from … radiological outcome subtrochanteric... 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