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Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Objective

To clinically and radiologically compare third-generation intramedullary nails used in the treatment of trochanteric hip fractures and to determine their efficacy.

Materials and methods

Seventy-five of 88 patients admitted to our hospital with trochanteric fractures were enrolled in the study; 43 were treated with PFNA devices and 32 with Intertan nails. The amount of compression applied during the procedure, duration of the procedure, amount of subsequent shortening in the proximal femoral area, subsequent backup of proximal screws, and changes in the tip-apex and tip-cortex distances were compared between groups. The postoperative change in the varus angle of the proximal femur and times to mobilization, full weight bearing, and fracture union were also evaluated.

Results

On early postoperative radiographs, the tip-apex distance was ≤25 mm in 86 % of patients in the PFNA group and 96.9 % of those in the Intertan group. Twelve months postoperatively, the tip-apex distance did not differ between groups. No cut-out of the screws into the coxofemoral joint was observed. Fracture healing was achieved in all patients. At 12 months postoperatively, the rates of proximal screw backup, proximal femoral shortening, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group.

Conclusions

Trochanteric fractures may be treated effectively with PFNA devices or Intertan nails. During the healing period, the rates of reverse displacement of the proximal screw, shortening of the proximal femur, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Surgical technique, implant positioning, and the choice of implant play roles in the successful treatment of trochanteric fractures.

Level of evidence

Level 1, prospective, prognostic study.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic and Traumatology, Kadikoy Acibadem Hospital, Istanbul, Turkey

    Mustafa Seyhan

  2. Department of Orthopaedics and Traumatology, Istanbul Beykoz State Hospital, Pasabahce D.H. Beykoz, Istanbul, Turkey

    Ismail Turkmen

  3. Department of Orthopaedics and Traumatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey

    Koray Unay & Afsar Timucin Ozkut

Authors
  1. Mustafa Seyhan
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  2. Ismail Turkmen
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  3. Koray Unay
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  4. Afsar Timucin Ozkut
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Corresponding author

Correspondence to Ismail Turkmen.

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The authors declare that there are no conflicts of interest.

Additional information

The study was performed in Istanbul Kadikoy Acibadem Hospital.

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Seyhan, M., Turkmen, I., Unay, K. et al. Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study. J Orthop Sci 20, 1053–1061 (2015). https://doi.org/10.1007/s00776-015-0750-4

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  • DOI: https://doi.org/10.1007/s00776-015-0750-4

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