Proximal femoral nail antirotation in treatment of. Comparison of proximal femoral nail antirotation pfna. Figure 1 from comparative study of the proximal femoral. Prior to steamsterilization, place the product in an approved wrap or contain. Instructions for use intramedullary nailing implants. The aoasif proximal femoral nail antirotation pfna.
Pfna with reduction assisted with pointed clamp and cable cerclage for select subtro. With augmentation option pfna ii set screw for trochanteric fixation nail. Fixation with the pfna nail synthes, paoli, pennsylvania b and bone union 3 months later c. In this preliminary series, no negative biological side effects of. Ipsilateral femoral neck and shaft fractures fixation with. Listing a study does not mean it has been evaluated by the u. All surgical techniques are available as pdf files at. Fixation of intertrochanteric femur fractures using. To compare the effects of proximal femoral nail antirotation blade pfna and reverse less invasive stabilization systemdistal femur lissdf systems in the treatment of proximal femoral fractures.
The surgery was prolonged due to the jamming of the implants. After autobone grafting for nonunion 4 months after. Comparative study of the proximal femoral nail antirotation versus the reconstruction nail in the treatment of comminuted proximal femoral. Traumatic complete expulsion of the blade should be considered as a possible complication of pfna pfna ii.
A cadaveric biomechanical study comparing the ease of femoral nail. In 2004, the aoasif group developed the proximal femoral nail antirotation pfna to improve the rotational and angular stability with one single element. Many biomechanical studies show the advantages of the spiral blade in the proximal femoral nail antirotation pfna. Examples include the gamma nail strykerhowmedica, the intramedullary hip screw smith and nephew richards, the proximal femoral nail synthes and the ace trochanteric nail depuy orthopaedics. At 5 months after surgery, the patient was able to walk with a walker without pain. Intraoperative outcomes favour pfna with less blood loss and fluoroscopy usage. Photograph showing a protrusion in the proximal lateral left thigh. Furthermore, the results ofthe primary treatment of osteoporotic proximal femur fractures are promising. Between june 2007 and october 2009, 41 proximal femoral fractures were treated, 22 with pfna group a and 19 with reverse liss.
Fixation with the recon nail zimmer, warsaw, indiana b. Both atns and pfna were suitable for the fixation of intertrochanteric fractures, but the. Proximal femoral nail antirotation surgical technique 1 determine entry point in ap view, the pfna entry point is on the tip or slightly lateral to the tip of the greater trochanter in the curved extension of the medullary cavity, as the ml angle of the pfna is 6. Surgery was performed according to the standard protocol for pfna synthes gmbh, switzerland or gamma3 stryker, mahwah, nj, usa based on the manufacturers instructions. Intertan nail versus proximal femoral nail antirotation. Table 2 from comparative study of the proximal femoral. The fractured and postoperative models were accordingly produced. Proximal femoral nail antirotation surgical technique. Do pfna devices and intertan nails both have the same effects in the treatment of trochanteric fractures. Suk kyu choo et al pfna and pfn in intertrochanteric fractures comparison study of sliding. The full text of this article is available in pdf format. It incorporates the best elements of our highly successful global hip nails tfn, pfna, and pfna ii, optimized through input from hundreds of surgeons around the world. Proximal femoral nail antirotation pfna synthes gmbh, oberdorf, switzerland in the lateral decubitus position.
Pfna blade rotational and angular stability achieved with one single element compaction of cancellous bone inserting. Between 2003 and 2010, twentythree consecutive patients with aoorthopaedic trauma association 31a3 fractures combined with proximal 32. A biomechanical comparison of two intramedullary implants. Pdf proximal femoral nail antirotation in treatment of. In the pfna ii group we encountered no impingement on the lateral cortex and no patients with lateral fragment or loss of reduction at insertion, whereas with the pfna. Pdf do pfna devices and intertan nails both have the. The augmentation improves implant anchorage in the impaired bone stock. The only intervention was intertan nail or pfna ii fixation of the unstable trochanteric fractures. Proximaler femurnagel antirotation operationstechnik.
Request pdf the new proximal femoral nail antirotationasia. Rotational and angular stability achieved with one sin gle element. The pfna proximal femur nail in treatment of unstable proximal femur fractures3 cases of postoperative perforation of the helical blade into the hip joint. In 2007, the aoasif developed the pfnaii also known as pfnaasia with sizes and geometry adapted to the femoral geometric proportions of asians. A 3d finite element model of an intact femur was constructed and validated. Improved design of pfna ii used to treat unstable trochanter fracture reduced complications related implant itself 21,22. Outcomes of combined neck and trochanter fractures of the. Comparison of proximal femoral nail antirotation blade and. The aim of this study was to evaluate whether proximal femoral fractures can be reduced and nailed properly in the lateral decubitus position without a traction table using pfna as a fixation device patients and methods. With augmentation option surgical technique rotational and angular stability achieved with one single element compaction of cancellous bone inserting the pfna blade compacts the cancellous bone providing additional anchoring, which is especially important in osteoporotic bone. During the study period, 37 out of the 410 patients 9. The pfna augmented proximal femoral nail antirotation, synthes inc. Proximal femoral nail antirotation pfna versus pfna. A 30yearold woman with a comminuted proximal femoral fracture a.
Pfna blades have been biomechanically proven to compact cancellous bone and achieve increased stability and thus to delay rotation. Comparison of a twin interlocking derotation and compression screw. The purpose of our study was to compare the proximal femoral nail antirotation pfna. The standard implant for pfna was a nail of 200 mm in length and 11 mm in diameter whereas the gamma3 used was a 180 mm nail of 11 mm diameter. Pdf comparative study of the proximal femoral nail. Radiographic outcomes of osteosynthesis using proximal femoral. Proximal femoral nail antirotation versus gamma3 nail for. After autobone grafting for nonunion 4 months after fi xation, fracture union occurred at 1 year c. Biomechanical effect of bone cement augmentation on rotational stability and pullout strength of the proximal femur nail. Cuttingout of the blade of the pfna is a rare complication buettler m, wyler e, attal r 2009 retrospective followup of patients with cutout after intramedullary nailing of proximal femur fractures with the pfna. Mostofthecomplicationsdocumentedinthe literature involved cutout and perforation of the femoral head by fig. A total of 2 consecutive patients with unstable trochanteric fractures of the femur were enrolled in the study. The pfna ii was removed and a cemented bipolar hemiarthroplasty was performed.
Depuy synthes companies at the depuy synthes companies, we are inspired by you. Under the special technique by using the pfna ii, all ten ca ses achieved optimal reduction and alignment. P f n a depuy synthes pdf catalogs technical documentation. Proximal femoral nail pfna nail the anatomical design guarantees an optimal fit in the femur. Between june 2007 and october 2009, 41 proximal femoral fractures were treated, 22 with pfna group a. Pdf does bone compaction around the helical blade of a proximal. Followup occurred at 1, 3, 6, and 12 months postoperatively. Synthes products supplied in a nonsterile condition must be cleaned and steamsterilized prior to surgical use. Because of the contradictory body of evidence related to the potential benefits of helical. A prospective clinical study article pdf available in. The pfna augmented is a potential implant for jointpreserving revision surgery in proximal femur fractures. In lateral view the entry point is in line with the axis of the. The pfna blade claims to compact the cancellous bone to provide increased stability and this has been biomechanically proven to retard rotation and varus collapse.
Comparison of proximal femoral nail antirotation pfna with ao. Does pfna ii avoid lateral cortex impingement for unstable. Comparison of second and thirdgeneration nails in the treatment. In the past ten years, the proximal femoral nail antirotation pfna ii device has been more widely used, and surgeons have also chosen pfna ii to treat basicervical. A number of different implant options are available for the management of this injury. To compare the effects of proximal femoral nail antirotation blade pfna and reverse less invasive stabilization system. The synthes proximal femoral nail antirotation pfna is unique because it. Intramedullary fixation with the pfna system synthes oberdorf.
Comparative study of the proximal femoral nail antirotation versus the reconstruction nail in the treatment of comminuted proximal femoral fracture. Pfna depuy synthes pdf catalogs technical documentation. Figure 2 from comparative study of the proximal femoral. Synthes, paoli, pennsylvania with a reconstruction nail recon. Management of lowenergy basicervical proximal femoral. The biomechanical effect of two implants, namely, proximal femoral nail antirotation for asia pfna ii and expert asian femoral nail a2fn, for treating subtrochanteric fracture during healing stages, is still unclear. Zimmer, warsaw, indiana in the treatment of comminuted proximal femoral fractures. However, surgical treatment using a cephalomedullary nail is still an alternative option that. Df systems in the treatment of proximal femoral fractures. Twodevice procedures were suggested because of the higher rate of malunion by singledevice treatment. It is the worlds largest maker of implants to mend bone fractures, 2 and also produces surgical power tools and advanced biomaterials.
Through our shared, strong relationships, we activate insights and translate our knowledge to provide lifechanging solutions. By joining the centre points of the bestfitting circles, the 3d centre circle. A 28yearold woman with a comminuted proximal femoral fracture a. We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. Orthopedics the purpose of our study was to compare the proximal femoral nail antirotation pfna. This site is published by the depuy synthes companies, which are solely responsible for its content. Proximal femoral nail antirotation pfna versus pfna augmentation the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Proximal femoral nail antirotation in treatment of fractures of proximal femur article pdf available in medical archives 683. Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. The technique guide for this implant suggests a distance from the. Synthes holding ag formerly synthes stratec is a multinational medical device manufacturer based in solothurn, switzerland and west chester, pennsylvania, united states. The blade and nail were eventually removed and replaced with an alternative product. Pfna, designed by ao in 2004, is an intramedullary device with a helical blade rather than a screw for better purchase in the femoral head 2, 3. The ease of insertion between tfna and pfna nails was quantified in terms of. To achieve rotational and angular stability, in 2004, the proximal femoral nail antirotation pfna device, one of the thirdgeneration intramedullary implants pfna. Femoral nail antirotation pfna ii synthes, solothurn, switzerland. Table 2 comparative study of the proximal femoral nail antirotation versus the reconstruction nail in the treatment of comminuted proximal femoral fracture. Comparison of a twin interlocking derotation and compression. Original article pfna with reduction assisted with pointed. A sawbone model was also utilized to perform the detailed technique of reduction and fixation of pfna ii.