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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Offset nail fixation for intertrochanteric fractures improves reduction and lag screw position
Takehiro Matsubara1,2, Kazuhito Soma3, Ikufumi Yamada4
1Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.
Plos One
|November 16, 2022
Summary
The Best Fit Nail (BFN) with anterior offset significantly improves intertrochanteric fracture surgery outcomes compared to non-offset nails. This orthopedic innovation reduces fragment displacement and enhances lag screw positioning for better patient results.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Intramedullary hip nails (IHNs) are standard for intertrochanteric fractures but can lead to complications like loss of reduction and cut-out.
- Investigating novel nail designs is crucial for improving surgical outcomes in treating these common fractures.
Purpose of the Study:
- To evaluate the efficacy of an anterior offset intramedullary hip nail (Best Fit Nail®, BFN) in maintaining fragment reduction and lag screw positioning.
- To compare the performance of the BFN against a conventional non-offset nail (Proximal Femoral Nail Antirotation®, PFNA) in intertrochanteric fracture surgery.
Main Methods:
- Retrospective analysis of 50 patients treated with BFNs and 50 with PFNAs for intertrochanteric fractures.
- Postoperative computed tomography (CT) scans were used to assess fragment displacement, reduction status, lag screw direction, and deviation angle.
Main Results:
- The BFN group showed significantly less fragment displacement (0 mm vs. 5.2 mm) and superior reduction status compared to the PFNA group (p<0.001).
- Lag screw deviation occurred less frequently (40% vs. 72%) and with a smaller angle in the BFN group compared to the PFNA group (p<0.001).
- No surgical adverse events were reported in either group.
Conclusions:
- Offset intramedullary hip nails, specifically the BFN, offer significant advantages over non-offset nails like PFNA for intertrochanteric fracture fixation.
- The BFN design promotes better fragment reduction and more accurate lag screw placement, potentially reducing complications associated with these fractures.
