Comparative study of intertrochanteric fracture fixation using proximal femoral nail with and without distal interlocking screws

doi:10.5312/wjo.v13.i3.267

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Orthop. Mar 18, 2022; 13(3): 267-277
Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.267

Comparative study of intertrochanteric fracture fixation using proximal femoral nail with and without distal interlocking screws

Nadeem A Lil, Vipul R Makwana, Tirth D Patel, Arjav R Patel

Nadeem A Lil, Vipul R Makwana, Tirth D Patel, Arjav R Patel, Department of Orthopaedics, NHL Medical College, Ahmedabad 380006, Gujarat, India

Author contributions: Lil NA, Makwana VR, Patel TD and Patel AR made substantial contributions to the study conception and design, to the acquisition, analysis and interpretation of data, and to the drafting of the article and making critical revisions related to important intellectual content of the manuscript; and all authors provided final approval of the version of the article to be published.

Institutional review board statement: This study was reviewed and approved by the NHL institutional review board (NHLIRB).

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: The authors declare that they do not have any conflicts of interest.

Data sharing statement: No additional data are available.

Corresponding author: Nadeem A Lil, MS, Professor, Department of Orthopaedics, NHL Medical College, Ellis Bridge, Ahmedabad 380006, Gujarat, India. nadeemlil@yahoo.com

Received: April 26, 2021
Peer-review started: April 26, 2021
First decision: July 28, 2021
Revised: August 7, 2021
Accepted: February 9, 2022
Article in press: February 9, 2022
Published online: March 18, 2022
Processing time: 324 Days and 22.9 Hours

ARTICLE HIGHLIGHTS

Research background

There are few studies comparing clinical and radiological outcomes between proximal femoral nail (PFN) with or without distal interlocking screws in fracture pattern Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2.

Research motivation

The motivation of this study was to assess the clinical and radiological outcomes of PFN with or without distal interlocking screws in fracture pattern AO/OTA 31-A1 and 31-A2, which were performed by the same chief surgeon.

Research objectives

The objective of this study was to compare the outcomes of intertrochanteric (IT) fractures (AO/OTA 31-A1 and 31-A2) treated by PFN with and without distal interlocking screws.

Research methods

We conducted a retrospective study of 140 patients having fracture pattern AO/OTA 31-A1 and 31-A2. We divided the patients into two groups based on distal interlocking. We evaluated patients based on clinical and radiological parameters like fracture type, duration of surgery and IITV radiation time, time for radiological union, proximal lock and distal lock-related complications, femoral neck shaft angle and length and rotation of limb after surgery.

Research results

There was no significant difference in radiological union, postoperative radiological alignment and proximal femur anatomy between patients with fracture pattern AO/OTA 31-A1 treated by PFN with or without distal interlocking. However, the incidence of proximal lock-related complications was higher in patients with fracture pattern AO/OTA 31-A2 treated by PFN with distal interlocking than in patients treated by PFN without distal interlocking.

Research conclusions

PFN without distal interlocking is a reliable and acceptable option for IT fracture types AO/OTA 31-A1 and 31-A2.

Research perspectives

A prospective study with long-term follow-up and a larger number of patients is necessary to draw a definitive conclusion.