Use of a Trochanteric Fixation Nail-Advanced (TFNA) with Cement Augmentation for Treatment of Trochanteric Fractures in Patients Greater Than Sixty Five Years of Age

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2022 Jan 16

PMID 35034146

Authors

Marie Fernandez

Yoann David

Frederic Dubrana

Remi Di Francia

Affiliations

Soon will be listed here.

Abstract

Purpose: Intramedullary nailing is the standard treatment of trochanteric fractures. Mechanical failure such as cut-out and cut-through are associated with high rates of revision surgery, functional impairment, and mortality. The aim of the study was to evaluate the rate of mechanical failure of the cement augmented screws of Trochanteric Fixation Nail-Advanced (TFNA) nails.

Patients And Methods: A descriptive, retrospective, multi-operator, single-centre study was performed at our level 1 trauma centre between June 2019 and June 2020. Patients were included if they were > 65 years of age, presented with a trochanteric fracture treated with an augmented TFNA nail with 6 months of follow-up. The primary outcome was fixation failure rate (cut-out or cut-through) at three and six post-operative months. Secondary endpoints were intra-operative data, clinical scores, and radiographic analysis.

Results: Forty-five patients (38 women and 7 men) were analysed. The mean age was 82.84 years (65-102, 9.50). There were no instances of mechanical failure in our series, after either three or six months of follow-up. No patient exhibited cut-out or cut-through. The mean amount of cement injected was 4.72 mL (3-6; 1.05). The mean length of surgery was 37.59 min (25-55; 6.48), and the mean intra-operative radiation exposure was 91.47 cGycm (25.04-201.81; 51.40) for a mean duration of 43.11 s (17-86; 16.81). The mean duration of hospitalisation was 6.38 days (2-11; 2.27).

Conclusions: Our clinical results suggest that cement-augmented TFNA screws can be successfully used in the management of trochanteric fractures in patients > 65 years of age.

Citing Articles

Augmented versus non-augmented Trochanteric Fixation Nail-Advanced (TFNA) nails for treating trochanteric fractures in patients over sixty-five years of age.

Fernandez M, Du Bourg V, David Y, Dubrana F, Letissier H, Di Francia R Int Orthop. 2023; 48(3):831-840.

PMID: 38159137 DOI: 10.1007/s00264-023-06073-5.

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