If advancement of the nail is difficult remove the nail and ream up another. 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. A wide variety of proximal femur nail options are available to you. Mechanical failures after fixation with proximal femoral nail and risk factors semmi koyuncu,1 task. Benefits of early intramedullary nailing in femoral metastases. Be sure that the nail slides free over the guide wire to prevent advancement of the guide wire distally. Complicated multiple trauma injuries, associated pelvic and acetabular frac tures. Pdf the treatment of trochanteric femoral fracture with. Proximal femoral nail versus dynamic hip screw fixation for. 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. Femoral universal femoral universal nailing system options.
To estimate the nail diameter, place the template on the lateral xray of the uninjured femur and measure the dia. Pdf short proximal femoral nail fixation for trochanteric. The short proximal femoral nail is a superior implant for stable and unstable intertrochanteric. Randomised comparison of the gamma nail and the pfn. Mechanical failures after fixation with proximal femoral. 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. Antegrade femoral nail afn surgical technique depuy synthes 9 determine nail diameter determine the distal nail diameter by placing the aoasif planning template on an ap image over the isthmus. Your child will be able to move his hip, knee and ankle on the operated side. Current techniques of femoral lengthening rely on gradual distraction with use of external fixation to form new bone in the distraction gap. Prep the hip limb free, circumferentially from the hemi pelvis to the toes, to ensure access to the lesser trochanter. Enter your mobile number or email address below and well send you a link to download the free kindle app. 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.
Phoenix antegrade femoral nail system featuring corelock. Common 5mm cortical screws simplify the surgical procedure and promote a minimally invasive approach. Solid and cannulated nails technique guide synthes paperback 1996. Jun 14, 20 this is an example of a surgery to fix a femur thigh bone fracture utilizing an intramedullary nail. Proximal femoral nails antirotation, gamma nails, and. Femoral neck fracture after removal of the standard gamma interlocking nail. 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. This material is intended for the sole use and benefit of the biomet sales force and health care. Retrograde femoral trigen metanail tibial trigen fan femoral antegrade nails. Femoral shaft fracture intramedullary nailing femur fracture. 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. Pdf treatment of the proximal femoral fractures with.
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. As the nail passes through the middle of the bone, it serves to. Intramedullary nails used for fixation of femoral fractures may require removal for a variety of reasons. In this presentation intramedullary nailing of the femur will be demonstrated using the expert a2fn. Proximal femoral nail antirotation versus gamma3 nail for intramedullary. Solid and cannulated nails technique guide synthes synthes on. Innovative technique article pdf available in open journal of orthopedics 0806. The joints will remain flexible and muscle strength. The purpose of this metaanalysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate. Reason and treatment of failure of proximal femoral nail. Operative treatment fixedangle nailplate devices the first successful implants were fixedangle nailplate devices e. All randomized controlled trials comparing proximal femoral nail and dynamic. Complex proximal femoral fractures in the elderly managed. Standard pfn and long pfn simple, reliable, versatile.
Apr 18, 2020 femoral nailing is a surgical technique used to treat a fractured or broken femur, or thighbone. Short proximal femoral nail fixation for trochanteric fractures. If the nail cannot be inserted, select a smaller size nail diameter. The femur was reconstructed with a new nail, and the fixation.
This serves not only to reduce the fracture, but also permits free access to the greater trochanter. Dec 01, 2016 the most common site for cancer to spread is bone. Pdf treatment of the intertrochanteric femoral fracture. 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. Lengthening of the femur with a remotecontrolled magnetic. Proximal femoral nail standard pfn and long pfn 12 1.
This is a minimally invasive way of fixing this surgical problem and allows for immediate range of motion and full weightbearing. Fractures involving the intertrochanteric region and subtrochanteric fractures were excluded, as open reduction was required. Ufn unreamed femoral nail cfn cannulated femoral nail. Finite element analysis of proximal femur nail for. 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.
In this paper, we present the management of a 40yearold man presented with a bent intramedullary nail due to secondary trauma. 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. The current status of prophylactic femoral intramedullary. The treatment of stable and unstable proximal femoral fractures with a new trochanteric nail. A cadaveric study to determine factors influencing the biomechanical properties of the proximal femur.
All nail insertions in acute cases should be performed using a traction table or a reduction device. Unfollow femoral nail to stop getting updates on your ebay feed. Cai 1department of orthopedic surgery, shanghai tenth peoples hospital, tongji university, school of medicine, shanghai, china. 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.
Since its introduction as a treatment for femoral and tibial shaft fractures, indications for use of intramedullary. Femoral nailing is a surgical technique used to treat a fractured or broken femur, or thighbone. Proximal femoral nail in reverse trochanteric femoral fractures. The patient is positioned supine on the traction table. Intramedullary nailing for femur fracture management. Retrograde femoral nailing has expanded the use of intramedullary nails 1, 2. Canal preparation nail selection figure 10 figure 11 surgical technique proximal end color pink darkgolden nail type left right neogen femoral nail. We propose to improve the use of proximal femoral nail antirotation in korea by reporting anatomical measurements of the normal korean. Find details of companies offering proximal femoral nail at best price. Short nail confirm that the femoral diaphysis is wide enough and long enough to allow the selected nail diameter to pass. 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. This is an example of a surgery to fix a femur thigh bone fracture utilizing an intramedullary nail.
The centronail titanium universal femoral nailing system. 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. A lateral longitudinal femoral osteotomy was used for the resection of the distorted nail. Utilizing the trigen sureshot distal targeting system. Kukla c, pichl w, prokesch r, jacyniak w, heinze g, gatterer r, et al. Reason and treatment of failure of proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures of senile patients j.
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. 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. Proximal femoral nail pfn are used to fix pertrochanteric, intertrochanteric, high subtrochanteric and transcervical fractures of the femur. Femoral lengthening over nail video journal of orthopaedics. Proximal femoral nail versus dynamic hip screw fixation. 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. Safe, rapid, and effortless femoral nail removal using a. Feb 04, 2017 in this presentation intramedullary nailing of the femur will be demonstrated using the expert a2fn. Orthopaedic advances motorized intramedullary nail for. 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. Proximal femoral nail antirotation versus gamma3 nail for. In most cases, neither a cast nor brace will be required postsurgery. With a growing aging population, the incidence of intertrochanteric fractures is rising. Failure of intramedullary femoral nail with segmental.
Femoral shaft fracture intramedullary nailing femur. Using controlled blows with the mallet, drive the nail into the distal femur. A secondary highvelocity trauma to a previously stabilized femoral fracture with intramedullary nailing is rare. Proximal femoral nails antirotation, gamma nails, and dynamic. 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. Zimmer natural nail system retrograde femoral nail surgical. Nail combines the principles of a compression hip screw with. Pdf trochanteric buttress plate combined with proximal. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. Pitfalls and complications in the use of the proximal femoral. Besides the t2 femoral nail with a 3m radius of curvature, stryker offers also a 1. Femoral universal femoral universal nailing system. Treatment of trochanteric fractures with proximal femoral nail.
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. Ream as necessary to enlarge the diaphysis to accept the selected nail. Trochanteric buttress plate combined with proximal femoral nail for unstable intertrochanteric fractures. 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. Long nail achei ve proper aigl nment of the inuj red lmi b pori r to reamni g. Phoenix antegrade femoral nail system featuring corelock technology 20 biomet orthopedics form no. The trigen tan and fan intramedullary nails are indicated for. 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. At postmortem, bony metastases have been found in 70% of patients dying from breast and prostate cancer. Affixus hip fracture nail surgical technique zimmer biomet. 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. Lavini f, renzi brivio l, aulisa r, cherubino f, di seglio pl, galante n, leonardi w, manca m. The rod is fixed by screws at both ends and will keep the bone stable in order to ensure proper healing. 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.
The unreamed femoral nail ufn and the cannulated femoral nail cfn are used to stabilize diaphyseal and metaphyseal fractures of the femur. Treatment of the intertrochanteric femoral fracture with proximal femoral nail. Some recommend that all such nails be removed after fracture healing,1,2 whereas others prefer to remove only those that cause symptoms. Complex proximal femoral fractures in the elderly managed by.
Plan the diameter of the nail on the basis of a measurement of the medullary canal on a calibrated radiograph. Proximal femoral nails antirotation, gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur. W grechenig, r szyszkowitzthe proximal femoral nail pfn a minimal invasive treatment of unstable proximal femoral fractures. Intramedullary nailing using the expert antegrade femoral. These techniques of distraction osteogenesis have two distinct phases of. Retograde nail antegrade femoral nail distal femoral nail supra condylar nail 6. A new design for the treatment of unstable proximal femoral fractures. Then you can start reading kindle books on your smartphone, tablet, or computer no kindle device required. Access is improved by inclining the trunk towards the uninjured side by about 25. 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. There were 21 prophylactic and 44 therapeutic nails with a mean followup of 15 months range 327. For the freehand distal locking screws, follow the proce dure described in section retrograde approach free hand locking, steps 2 to 6. The aoasif proximal femoral nail antirotation pfna.
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