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Cephalomedullary fixation for intertrochanteric fractures: an operative technical tip

Intertrochanteric fracture is the most common hip fractures in elderly population. Cephalomedullary fixation, including proximal femoral nail antirotation (PFNA) and gamma nail, is commonly used in the treatment of intertrochanteric fractures. One of difficulties encountered in operation is insertio... Full description

Journal Title: European Journal of Orthopaedic Surgery & Traumatology 2014, Vol.24(7), pp.1317-1320
Main Author: Jin, Lin
Other Authors: Zhang, Liping , Hou, Zhiyong , Chen, Wei , Wang, Pengcheng , Zhang, Yingze
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 1633-8065 ; E-ISSN: 1432-1068 ; DOI: 10.1007/s00590-014-1430-3
Link: http://dx.doi.org/10.1007/s00590-014-1430-3
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recordid: springer_jour10.1007/s00590-014-1430-3
title: Cephalomedullary fixation for intertrochanteric fractures: an operative technical tip
format: Article
creator:
  • Jin, Lin
  • Zhang, Liping
  • Hou, Zhiyong
  • Chen, Wei
  • Wang, Pengcheng
  • Zhang, Yingze
subjects:
  • Intertrochanteric fractures
  • Cephalomedullary fixation
  • Guide wire
  • Technique
ispartof: European Journal of Orthopaedic Surgery & Traumatology, 2014, Vol.24(7), pp.1317-1320
description: Intertrochanteric fracture is the most common hip fractures in elderly population. Cephalomedullary fixation, including proximal femoral nail antirotation (PFNA) and gamma nail, is commonly used in the treatment of intertrochanteric fractures. One of difficulties encountered in operation is insertion of the guide wire to femoral head. The guide wire would always bend and flow superiorly away from femoral calcar, and the lag screw and helical blade will follow the track and get into superior part of femoral head, not into femoral calcar. Here, we are presenting a surgical technique to direct the guide wire to right track. When guide wire just passed the tack hole of the nail, the rod of nail was slightly tapped down further to allow the superior border of the tack hole to touch the guide wire. Therefore, the superior border of the tack hole can be used as presser to prevent the wire from deviating upward. Through this way, the lag screw and helical blade get a good purchase that docked at femoral calcar. After that, the rod of nail was pulled back a little to make the wire in the middle of the tack hole, which can facilitate the insertion of the PFNA blade or lag screw. Our experience demonstrated that this surgical technique reduced the intraoperative risk for patients.
language: eng
source:
identifier: ISSN: 1633-8065 ; E-ISSN: 1432-1068 ; DOI: 10.1007/s00590-014-1430-3
fulltext: fulltext
issn:
  • 1432-1068
  • 14321068
  • 1633-8065
  • 16338065
url: Link


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titleCephalomedullary fixation for intertrochanteric fractures: an operative technical tip
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subjectIntertrochanteric fractures ; Cephalomedullary fixation ; Guide wire ; Technique
descriptionIntertrochanteric fracture is the most common hip fractures in elderly population. Cephalomedullary fixation, including proximal femoral nail antirotation (PFNA) and gamma nail, is commonly used in the treatment of intertrochanteric fractures. One of difficulties encountered in operation is insertion of the guide wire to femoral head. The guide wire would always bend and flow superiorly away from femoral calcar, and the lag screw and helical blade will follow the track and get into superior part of femoral head, not into femoral calcar. Here, we are presenting a surgical technique to direct the guide wire to right track. When guide wire just passed the tack hole of the nail, the rod of nail was slightly tapped down further to allow the superior border of the tack hole to touch the guide wire. Therefore, the superior border of the tack hole can be used as presser to prevent the wire from deviating upward. Through this way, the lag screw and helical blade get a good purchase that docked at femoral calcar. After that, the rod of nail was pulled back a little to make the wire in the middle of the tack hole, which can facilitate the insertion of the PFNA blade or lag screw. Our experience demonstrated that this surgical technique reduced the intraoperative risk for patients.
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titleCephalomedullary fixation for intertrochanteric fractures: an operative technical tip
descriptionIntertrochanteric fracture is the most common hip fractures in elderly population. Cephalomedullary fixation, including proximal femoral nail antirotation (PFNA) and gamma nail, is commonly used in the treatment of intertrochanteric fractures. One of difficulties encountered in operation is insertion of the guide wire to femoral head. The guide wire would always bend and flow superiorly away from femoral calcar, and the lag screw and helical blade will follow the track and get into superior part of femoral head, not into femoral calcar. Here, we are presenting a surgical technique to direct the guide wire to right track. When guide wire just passed the tack hole of the nail, the rod of nail was slightly tapped down further to allow the superior border of the tack hole to touch the guide wire. Therefore, the superior border of the tack hole can be used as presser to prevent the wire from deviating upward. Through this way, the lag screw and helical blade get a good purchase that docked at femoral calcar. After that, the rod of nail was pulled back a little to make the wire in the middle of the tack hole, which can facilitate the insertion of the PFNA blade or lag screw. Our experience demonstrated that this surgical technique reduced the intraoperative risk for patients.
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abstractIntertrochanteric fracture is the most common hip fractures in elderly population. Cephalomedullary fixation, including proximal femoral nail antirotation (PFNA) and gamma nail, is commonly used in the treatment of intertrochanteric fractures. One of difficulties encountered in operation is insertion of the guide wire to femoral head. The guide wire would always bend and flow superiorly away from femoral calcar, and the lag screw and helical blade will follow the track and get into superior part of femoral head, not into femoral calcar. Here, we are presenting a surgical technique to direct the guide wire to right track. When guide wire just passed the tack hole of the nail, the rod of nail was slightly tapped down further to allow the superior border of the tack hole to touch the guide wire. Therefore, the superior border of the tack hole can be used as presser to prevent the wire from deviating upward. Through this way, the lag screw and helical blade get a good purchase that docked at femoral calcar. After that, the rod of nail was pulled back a little to make the wire in the middle of the tack hole, which can facilitate the insertion of the PFNA blade or lag screw. Our experience demonstrated that this surgical technique reduced the intraoperative risk for patients.
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doi10.1007/s00590-014-1430-3
pages1317-1320
date2014-10