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A retrospective comparative study of the clinical and radiological outcomes of intertrochanteric fractures treated with proximal femoral nail antirotation (PFN-A) and INTERTAN nail.
PLoS One
January 2025
Çukurova University Faculty of Medicine, Department of Orthopedics and Traumatology, Adana, Türkiye.
Background: This study aimed to analyze the files of patients treated using PFN-A or INTERTAN intramedullary nails to reveal additional superiorities or disadvantageous factors for selecting the better intramedullary fixation method in patients presenting with intertrochanteric femur fractures.
Methods: In this retrospective study, the files of the patients who were operated on for intertrochanteric femur fractures using intramedullary fixation methods between September 2010 and June 2015 in the Orthopedics and Traumatology Clinic, Çukurova University Faculty of Medicine, were reviewed. The data including age, gender, chronic diseases, causes of fractures, fracture classification based on Arbeitsgemeinschaft für Osteosynthesefragen (AO), the nail type (long or short), the interval between trauma and surgery, duration of anesthesia and surgery, hospitalization duration, amount of blood transfusion, the Tip-Apex Distance (TAD) in postoperative radiographs, functional outcomes according to Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), postoperative complications, need for revision, and mortality was noted.
Percutaneous Screw Fixation of Proximal Fifth Metatarsal Fractures.
JBJS Essent Surg Tech
November 2024
Department of Orthopaedics Foot and Ankle Surgery, The Ohio State University, Columbus, Ohio.
Article Synopsis
- Metatarsal fractures, particularly affecting the fifth metatarsal, are common injuries, making up 5-6% of outpatient fractures, with zone 2 fractures—specifically Jones fractures—being difficult to manage due to poor blood supply and higher nonunion rates.
- Surgical treatment, particularly open reduction and internal fixation (ORIF), is preferred for Jones fractures, as it leads to better healing rates compared to conservative treatment methods.
- The surgical technique involves careful anatomical marking and using a guidewire for screw placement to compress the fracture, followed by a recovery period that includes non-weight-bearing and gradual weight-bearing activities.*
Pathophysiology of longitudinal forearm instability (Essex-Lopresti syndrome) and implications for treatment.
Hand Surg Rehabil
December 2024
Service de Chirurgie de la Main et du Membre Supérieur - Chirurgie des Paralysies, CHU LAPEYRONIE, 371, Avenue du Doyen Gaston GIRAUD, 34295 Montpellier cedex, France.
Article Synopsis
- Longitudinal forearm instability, or Essex-Lopresti syndrome, is characterized by a combination of radial head fractures and ruptured connective structures between the radius and ulna, which often goes unnoticed initially.
- Prompt treatment within 4 weeks is important to prevent complications, involving procedures like rigid radial head replacement and surgical repair of surrounding tissues
- If treatment is delayed beyond 4 weeks, more complex interventions are needed, including reconstruction of the interosseous membrane, with less certain outcomes.
Predictors for 1-year mortality in geriatric patients following fragile intertrochanteric fracture surgery.
J Orthop Surg Res
October 2024
Department of Emergency Surgery, Affiliated Hospital of Jining Medical University, No. 89, Guhuai Road, Jining City, 272029, Shandong Province, China.
Objective: To investigate the risk factors influencing 1-year mortality after intramedullary nail fixation for fragile intertrochanteric fracture in elderly individuals.
Methods: The medical records of 622 consecutive elderly patients (aged ≥ 65 years) with fragile intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) and followed-up were retrospectively analyzed. The patients were divided into death and survival groups according to their survival status within 1 year after surgery, and the differences in age, sex, region of residence, tobacco use, alcohol use, body mass index (BMI), comorbidities (hypertension, diabetes mellitus, coronary heart disease, stroke, dementia, chronic obstructive pulmonary disease, pneumonia), preoperative hemoglobin, preoperative albumin, deep vein thrombosis, fracture type (AO classification), injury-to-surgery time, American Society of Anesthesiologists (ASA) score, anesthesia modality, duration of surgery, intraoperative blood loss, and blood transfusion were compared.
[Intramedullary nailing of coated and uncoated nails in infected tibial pseudarthrosis : Results of a retrospective examination of 56 patients].
Unfallchirurgie (Heidelb)
November 2024
Klinik für Orthopädie und Unfallchirurgie, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Deutschland.
Article Synopsis
- The study investigates the effectiveness of tibial intramedullary nails in treating chronic osteomyelitis, specifically comparing gentamycin-coated nails (ETNs) and uncoated nails (UCNs) in a group of previously treated patients.
- Out of 56 patients analyzed, postoperative complications occurred in 45%, with a slightly higher rate in the ETN group; however, 86% achieved bony consolidation, indicating that the procedure has potential benefits despite risks.
- The authors conclude that while complications exist, the process offers significant functional advantages like stability and comfort, with an acceptable risk of reinfection, making it a viable option for treating chronic osteomyelitis. *
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