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Proximal Femoral Nail Pdf Free
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Maryetta Worm
Dec 5, 2023, 12:15:26 AM12/5/23
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Given the ever-increasing rate of failure related to proximal femoral nail antirotation (PFNA), it is expected that an increasing number of PFNA individuals will undergo conversion to total hip arthroplasty (THA). The long-term survivorship of conversion of the initial PFNA to cemented THA is still debated. The aim of this retrospective study was to assess the long-term revision-free survivorship of cemented THAs after initial failures of PFNA in geriatric individuals.
Implant failure secondary to proximal femoral nail antirotation (PFNA) is a disabling complication of hip surgery [1,2,3]. Patients with failed PFNA are frequently accompanied by a noteworthy risk of death, increased cardia-cerebrovascular events, and reduced limb movement function and may experience conversion to total hip arthroplasty (THA) if there are no contraindications [4, 5]. Evidence-based best practice [6, 7] shows that THA is an expected solution to manage a failed PFNA, as it has reliable clinical outcomes and allows early rehabilitation and functional recovery, yet distrust remains as to a cemented or uncemented THA to apply in attempts to achieve superior clinical outcomes. With the burden of conversion to THA predicted to climb at a tremendous rate with the aging of the population, the survival of conversion of the initial PFNA to THA has been a growing concern [1, 8, 9]. This concern is further animated by the fact that the conversion to THA exposes patients to a leading challenge on the femur side, particularly when extensive bone loss and/or fractures occur [10]. Under such conditions, cemented THA may contribute significantly to enhancing hip stability and improving wear-resistant bearings [10, 11]. Patients experiencing cemented THA may achieve long-term prosthetic survival, as concerns related to prosthesis dislocations have been moderated with the application of larger-diameter heads and enhanced ligament patch-up methods [12, 13].
Proximal Femoral Nail Pdf Free
Download https://shoxet.com/2wIfEx
Cheng and Sheng compared eight treatment options for intertrochanteric fractures [dynamic hip screw, compression hip, percutaneous compression plate, Medoff sliding plate, less invasive stabilisation system, gamma nail, proximal femoral nail, and proximal femoral nail anti-rotating (PFNA)] and identified PFNA as the preferable surgical method with fewer blood loss and high functional outcomes, according to the Harris hip score [51]. When using intramedullary nails, the use of a helical blade in comparison to a lag screw is associated with a higher rate of collapse of the neck-shaft angle and the concomitant dislocation of the screw (cut-out) in the femoral head [50].
The Dorr type and the cortical thickness are key factors in estimating the risk of an intraoperative fracture when placing the prosthesis and can thus help guiding the choice of the fixation method. The Dorr description of the proximal femoral morphology correlates with a low cortical thickness index [64]. In comparison to type A, Dorr type B and C indicate a higher risk of intraoperative fracture [64].
Accounting for only 1.8% of all PFFs, basicervical femoral neck fractures are quite uncommon [67]. The treatment options include both a cephalomedullary nail, a dynamic hip screw and cancellous screws. When the latter were used, a higher failure rate was observed [67]. Reviewing treatments and failures of basicervical femoral neck fractures, Yoo et al. stated that further research with a homogenous definition on treatment results or fixation failure are needed to perform a meta-analysis for clear recommendations [67].
Implants for proximal femoral nailing PROXIMAL FEMORAL NAILING System of implants: Proximal femoral nail, short: solid or cannulated, distal diameter 9 -12 mm, proximal diameter 17,6 mm, with CCD angle 130 or 135, lenght from 180 to 240 mm, steel or titanium alloy Dynamic screw: Thread diameter 9,5 mm, core diameter 6,0 mm, pitch 3,0 mm, steel or titanium alloy Antirotation screw: Thread diameter 6,5 mm, core diameter 3,4 mm, length from 55 mm to 130 mm, steel or titanium alloy Locking screw: diameter 4,9 mm, legth from 20 mm to 100 mm, steel or titanium alloy End cup: steel (cat. nr....
Proximal femoral nail with antirotation screw, short Proximal diameter: 17,6 mm Material: steel or titanium alloy Dynamic screw: from 12710-95075 to 12710-95145 (steel) from 32710-95075 to 32710-95145 (titanium alloy) Antirotation screw: from 12210-65055 to 12210-65130 (steel) from 32210-65055 to 32210-65130 (titanium alloy) Locking screw: from 12200-49020 to 12200-49100 (steel) from 32200-49020 to 32200-49100 (titanium alloy) Cap screw: 12400-17016 (steel), 32400-17016 (titanium alloy) Catalogue number L (mm) (mm) titanium alloy titanium alloy PROXIMAL FEMORAL NAILING Implants for proximal...
Implants for proximal femoral nailing PROXIMAL FEMORAL NAILING 6 Proximal femoral nail with antirotation screw, cannulated, long, left, right Catalogue number L (mm) (mm) cannulated, left cannulated, right titanium alloy titanium alloy
Dynamic screw for proximal femoral nail Thread diameter: 9,5 mm Core diameter: 6,0 mm Pitch: 3,0 mm Catalogue number L (mm) 75 80 85 90 95 100 105 titanium alloy Antirotation screw for proximal femoral nail Thread diameter: Core diameter: Pitch: Hex width: titanium alloy PROXIMAL FEMORAL NAILING Implants for proximal femoral nailing Locking screw for short and long proximal femoral nail Thread diameter: Core diameter: Pitch: Head diameter: Hex width: L (mm) 20 22 24 25 26 28 30 32 34 35 36 38 40 titanium alloy
Surgical instruments for proximal femoral nailing PROXIMAL FEMORAL NAILING Surgical set Two trays for proximal femoral nailing instrumet set, complete with instruments: cat. nr. 94650-00000 Tray I. for proximal femoral nailing Description Proximal targeting arm, radiolucent Aiming arm attachment, 135 Aiming arm attechment, 130 Compressing device Hollow reamer Slide hammer Hammer guide head T wrench Hammer guide shaft Aiming arm fixing screw Gauge for dynamic screw Nail adapter screw Threaded stem for dynamic screw Aiming arm clamp screw Kirschner wire, 3,5 400 mm
PROXIMAL FEMORAL NAILING Surgical instruments for proximal femoral nailing Tray II. for proximal femoral nailing Cat. nr. 94650-20000 Description Universal chuck with T handle Drill sleeve for antirotation screw, (yellow) Wrench, 12 mm Wrench, 17 mm Cardan screw driver with quick coupling Cardan rod for removal device Hexagonal screwdriver, 3,5 mm Fixation sleeve for removal device Soft tissue protector for dynamic screw, (red) Drill sleeve for guide wire, (red) Soft tissue protector for locking screw, (green) Drill sleeve for distal locking drill (green) Soft tissue protector for...
Proximal femoral nail anti-rotation (PFNA) is a routine method to deal with intertrochanteric fractures in the elder population. It is challenging to remove PFNA in some cases as a result of stripping of blade heads. In this case presentation, we describe a novel technique using commonly available instruments that can be used to remove stripped, even broken anti-rotation blade where conventional methods have failed.
Owing to an aging population, the incidence of proximal femoral fractures continues to rise. Intertrochanteric fractures are of the most common fracture types, which are routinely treated with proximal femoral nail anti-rotation (PFNA) today. Compared with plate-screw fixation, various researches suggest that PFNA is a better choice for the treatment for unstable peritrochanteric fractures [1]. With the enhancement of the technique, the effects have increased, and complications have reduced. However, when we intend to remove the implant, orthopedic surgeons are frequently faced with the challenge of removing the anti-rotation blade when the blind nut of it stripped. None of simple and effective methods for extraction of PFNA has been previously described. We describe a novel technique using a commonly available instrument that can be used to remove stripped even broken anti-rotation blade where regular methods have failed.
(SBQ18TR.50) A 32-year-old male sustained a left femoral shaft fracture after a boating accident. He is treated with a retrograde femoral nail with an uncomplicated postoperative course. He presents 11-months postop with persistent thigh pain that is worse with weight-bearing. His current radiographs are demonstrated in figure A. His current ESR and C-reactive protein are 12 mm/hr (reference
(OBQ18.241) A 28-year-old male that sustained a closed left femoral shaft fracture 12 months ago and underwent intramedullary nailing presents with persistent pain in the right thigh. The patient walks with an antalgic gait. He denies any fevers or chills. His surgical sites are well healed and there are no signs of drainage. Serum ESR and CRP are 12 mm/hr (reference
(OBQ16.235) A 55-year-old male is involved in a motorcycle crash and sustains a closed, right-sided, midshaft femur fracture. This is an isolated injury. He is treated with retrograde femoral nailing, and post-operatively is noted to have 30 degrees of internal rotation of the operative extremity, when compared with his nonsurgical side. Which of the following is the most likely cause of this malrotation deformity?
(OBQ13.201) A radiologist uses CT scans to perform research on rotational malalignment of femoral shaft fractures treated with intramedullary nailing. He determines the angle between a line drawn tangential to the femoral condyles and a line drawn through the axis of the femoral neck. He does this for both the injured and uninjured sides. In Figure A, what malalignment is present for the injured left side compared with the uninjured right side?
(OBQ13.10) A 35-year-old man is thrown from his vehicle and sustains a left proximal femoral shaft fracture and right distal femoral shaft fracture. The surgeon elects to treat both fractures with reamed intramedullary nailing. Which of the following is true regarding the risk of malrotation?
(OBQ13.144) A 23-year-old man undergoes intramedullary nailing for a comminuted right femur fracture. Three weeks after surgery, CT scans are performed to assess for rotational malalignment. In Figure A, the angular rotation of the right femoral neck is internal rotation of 13 while the angular rotation of the left femoral neck is external rotation of 13. In Figure B, the angular rotation of the right and left femoral condyles is external rotation of 17 and 3, respectively. At revision surgery, in order to correct the rotational malalignment, the right distal femur must be rotated which of the following?
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Implant failure secondary to proximal femoral nail antirotation (PFNA) is a disabling complication of hip surgery [1,2,3]. Patients with failed PFNA are frequently accompanied by a noteworthy risk of death, increased cardia-cerebrovascular events, and reduced limb movement function and may experience conversion to total hip arthroplasty (THA) if there are no contraindications [4, 5]. Evidence-based best practice [6, 7] shows that THA is an expected solution to manage a failed PFNA, as it has reliable clinical outcomes and allows early rehabilitation and functional recovery, yet distrust remains as to a cemented or uncemented THA to apply in attempts to achieve superior clinical outcomes. With the burden of conversion to THA predicted to climb at a tremendous rate with the aging of the population, the survival of conversion of the initial PFNA to THA has been a growing concern [1, 8, 9]. This concern is further animated by the fact that the conversion to THA exposes patients to a leading challenge on the femur side, particularly when extensive bone loss and/or fractures occur [10]. Under such conditions, cemented THA may contribute significantly to enhancing hip stability and improving wear-resistant bearings [10, 11]. Patients experiencing cemented THA may achieve long-term prosthetic survival, as concerns related to prosthesis dislocations have been moderated with the application of larger-diameter heads and enhanced ligament patch-up methods [12, 13].
Proximal Femoral Nail Pdf Free
Download https://shoxet.com/2wIfEx
Cheng and Sheng compared eight treatment options for intertrochanteric fractures [dynamic hip screw, compression hip, percutaneous compression plate, Medoff sliding plate, less invasive stabilisation system, gamma nail, proximal femoral nail, and proximal femoral nail anti-rotating (PFNA)] and identified PFNA as the preferable surgical method with fewer blood loss and high functional outcomes, according to the Harris hip score [51]. When using intramedullary nails, the use of a helical blade in comparison to a lag screw is associated with a higher rate of collapse of the neck-shaft angle and the concomitant dislocation of the screw (cut-out) in the femoral head [50].
The Dorr type and the cortical thickness are key factors in estimating the risk of an intraoperative fracture when placing the prosthesis and can thus help guiding the choice of the fixation method. The Dorr description of the proximal femoral morphology correlates with a low cortical thickness index [64]. In comparison to type A, Dorr type B and C indicate a higher risk of intraoperative fracture [64].
Accounting for only 1.8% of all PFFs, basicervical femoral neck fractures are quite uncommon [67]. The treatment options include both a cephalomedullary nail, a dynamic hip screw and cancellous screws. When the latter were used, a higher failure rate was observed [67]. Reviewing treatments and failures of basicervical femoral neck fractures, Yoo et al. stated that further research with a homogenous definition on treatment results or fixation failure are needed to perform a meta-analysis for clear recommendations [67].
Implants for proximal femoral nailing PROXIMAL FEMORAL NAILING System of implants: Proximal femoral nail, short: solid or cannulated, distal diameter 9 -12 mm, proximal diameter 17,6 mm, with CCD angle 130 or 135, lenght from 180 to 240 mm, steel or titanium alloy Dynamic screw: Thread diameter 9,5 mm, core diameter 6,0 mm, pitch 3,0 mm, steel or titanium alloy Antirotation screw: Thread diameter 6,5 mm, core diameter 3,4 mm, length from 55 mm to 130 mm, steel or titanium alloy Locking screw: diameter 4,9 mm, legth from 20 mm to 100 mm, steel or titanium alloy End cup: steel (cat. nr....
Proximal femoral nail with antirotation screw, short Proximal diameter: 17,6 mm Material: steel or titanium alloy Dynamic screw: from 12710-95075 to 12710-95145 (steel) from 32710-95075 to 32710-95145 (titanium alloy) Antirotation screw: from 12210-65055 to 12210-65130 (steel) from 32210-65055 to 32210-65130 (titanium alloy) Locking screw: from 12200-49020 to 12200-49100 (steel) from 32200-49020 to 32200-49100 (titanium alloy) Cap screw: 12400-17016 (steel), 32400-17016 (titanium alloy) Catalogue number L (mm) (mm) titanium alloy titanium alloy PROXIMAL FEMORAL NAILING Implants for proximal...
Implants for proximal femoral nailing PROXIMAL FEMORAL NAILING 6 Proximal femoral nail with antirotation screw, cannulated, long, left, right Catalogue number L (mm) (mm) cannulated, left cannulated, right titanium alloy titanium alloy
Dynamic screw for proximal femoral nail Thread diameter: 9,5 mm Core diameter: 6,0 mm Pitch: 3,0 mm Catalogue number L (mm) 75 80 85 90 95 100 105 titanium alloy Antirotation screw for proximal femoral nail Thread diameter: Core diameter: Pitch: Hex width: titanium alloy PROXIMAL FEMORAL NAILING Implants for proximal femoral nailing Locking screw for short and long proximal femoral nail Thread diameter: Core diameter: Pitch: Head diameter: Hex width: L (mm) 20 22 24 25 26 28 30 32 34 35 36 38 40 titanium alloy
Surgical instruments for proximal femoral nailing PROXIMAL FEMORAL NAILING Surgical set Two trays for proximal femoral nailing instrumet set, complete with instruments: cat. nr. 94650-00000 Tray I. for proximal femoral nailing Description Proximal targeting arm, radiolucent Aiming arm attachment, 135 Aiming arm attechment, 130 Compressing device Hollow reamer Slide hammer Hammer guide head T wrench Hammer guide shaft Aiming arm fixing screw Gauge for dynamic screw Nail adapter screw Threaded stem for dynamic screw Aiming arm clamp screw Kirschner wire, 3,5 400 mm
PROXIMAL FEMORAL NAILING Surgical instruments for proximal femoral nailing Tray II. for proximal femoral nailing Cat. nr. 94650-20000 Description Universal chuck with T handle Drill sleeve for antirotation screw, (yellow) Wrench, 12 mm Wrench, 17 mm Cardan screw driver with quick coupling Cardan rod for removal device Hexagonal screwdriver, 3,5 mm Fixation sleeve for removal device Soft tissue protector for dynamic screw, (red) Drill sleeve for guide wire, (red) Soft tissue protector for locking screw, (green) Drill sleeve for distal locking drill (green) Soft tissue protector for...
Proximal femoral nail anti-rotation (PFNA) is a routine method to deal with intertrochanteric fractures in the elder population. It is challenging to remove PFNA in some cases as a result of stripping of blade heads. In this case presentation, we describe a novel technique using commonly available instruments that can be used to remove stripped, even broken anti-rotation blade where conventional methods have failed.
Owing to an aging population, the incidence of proximal femoral fractures continues to rise. Intertrochanteric fractures are of the most common fracture types, which are routinely treated with proximal femoral nail anti-rotation (PFNA) today. Compared with plate-screw fixation, various researches suggest that PFNA is a better choice for the treatment for unstable peritrochanteric fractures [1]. With the enhancement of the technique, the effects have increased, and complications have reduced. However, when we intend to remove the implant, orthopedic surgeons are frequently faced with the challenge of removing the anti-rotation blade when the blind nut of it stripped. None of simple and effective methods for extraction of PFNA has been previously described. We describe a novel technique using a commonly available instrument that can be used to remove stripped even broken anti-rotation blade where regular methods have failed.
(SBQ18TR.50) A 32-year-old male sustained a left femoral shaft fracture after a boating accident. He is treated with a retrograde femoral nail with an uncomplicated postoperative course. He presents 11-months postop with persistent thigh pain that is worse with weight-bearing. His current radiographs are demonstrated in figure A. His current ESR and C-reactive protein are 12 mm/hr (reference
(OBQ18.241) A 28-year-old male that sustained a closed left femoral shaft fracture 12 months ago and underwent intramedullary nailing presents with persistent pain in the right thigh. The patient walks with an antalgic gait. He denies any fevers or chills. His surgical sites are well healed and there are no signs of drainage. Serum ESR and CRP are 12 mm/hr (reference
(OBQ16.235) A 55-year-old male is involved in a motorcycle crash and sustains a closed, right-sided, midshaft femur fracture. This is an isolated injury. He is treated with retrograde femoral nailing, and post-operatively is noted to have 30 degrees of internal rotation of the operative extremity, when compared with his nonsurgical side. Which of the following is the most likely cause of this malrotation deformity?
(OBQ13.201) A radiologist uses CT scans to perform research on rotational malalignment of femoral shaft fractures treated with intramedullary nailing. He determines the angle between a line drawn tangential to the femoral condyles and a line drawn through the axis of the femoral neck. He does this for both the injured and uninjured sides. In Figure A, what malalignment is present for the injured left side compared with the uninjured right side?
(OBQ13.10) A 35-year-old man is thrown from his vehicle and sustains a left proximal femoral shaft fracture and right distal femoral shaft fracture. The surgeon elects to treat both fractures with reamed intramedullary nailing. Which of the following is true regarding the risk of malrotation?
(OBQ13.144) A 23-year-old man undergoes intramedullary nailing for a comminuted right femur fracture. Three weeks after surgery, CT scans are performed to assess for rotational malalignment. In Figure A, the angular rotation of the right femoral neck is internal rotation of 13 while the angular rotation of the left femoral neck is external rotation of 13. In Figure B, the angular rotation of the right and left femoral condyles is external rotation of 17 and 3, respectively. At revision surgery, in order to correct the rotational malalignment, the right distal femur must be rotated which of the following?
eebf2c3492
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