Volume 9, 2023
|Number of page(s)||5|
|Published online||05 June 2023|
Reduced cutout for reverse oblique intertrochanteric hip fractures treated with trochanteric fixation advanced (TFN-A) nail compared to the short gamma-3 nail
Division of Orthopedics, Tel Aviv Sourasky Medical Center, Tel-Aviv, Affiliated to the Sackler Faculty of Medicine Tel Aviv University, Tel Aviv 6423906, Israel
2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel
* Corresponding author: firstname.lastname@example.org
Accepted: 23 April 2023
Background: Reverse oblique fractures (AO/OTA 31-A3) account for 5–23% of all intertrochanteric fractures and are challenging to manage. The Gamma 3-Proximal Femoral Nail (GPFN) and the Trochanteric Fixation Nail Advanced (TFNA) are two common cephalomedullary systems used to treat this fracture. No study has reported on outcomes with the TFN-A for reverse oblique fractures. This study aimed to compare outcomes and complication rates in patients with reverse oblique fractures, treated with either TFNA or GPFN. Patients and methods: A total of 203 patients with reverse oblique fractures (137 in the GPFN group and 66 in the TFNA group), were treated in our institution between June 2010 and May 2019. Data was collected on postoperative radiological variables including screw or blade location, and tip-apex distance (TAD). Data were also collected for non-orthopaedic complication rates and orthopaedic complications. A sub-group analysis was additionally performed for different nail lengths. Results: We found no significant difference in the overall rate of complications and revisions between the two groups. Patients treated with the 235 mm TFN-A nail sustained lower rates of cutout, compared to 180 mm GPFN (GPFN: 6% TFN-A: 0%, p = 0.043). The frequency of revision surgeries and malunions/non-unions did not differ significantly between the two groups and additionally showed no difference in the subgroup analysis. Conclusion: The 235 mm TFN-A was associated with lower rates of cut-out compared to the short GPFN for reverse oblique intertrochanteric fractures. Future well-designed prospective studies are warranted to investigate the role of the TFN-A in improving outcomes for such fractures.
Key words: Reverse oblique fracture / TFNA nail / Gamma 3 nail
© The Authors, published by EDP Sciences, 2023
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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