NEW GENERATION NAIL VS. PLATE IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURE

PREGOS DE NOVA GERAÇÃO CONTRA A PLACA NO TRATAMENTO DE FRATURAS DE FÊMUR INTERTROCANTÉRICAS INSTÁVEIS

ABSTRACT

Objective:

To compare antirotator proximal femoral nail (A-PFN) with antirotator dynamic hip screw (A-DHS).

Methods:

Fourteen proximal femur models with type 31/A2 fracture, according to the AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification, were separated into two groups. Group 1 bones (n = 7) were fixed with A-PFN and Group 2 (n = 7) with A-DHS. A 5 mm/min axial load was applied to femur heads using a testing device.

Results:

Two of the seven models in the A-PFN group fractured at the proximal, and the other five at distal locking screw level. All models in the A-DHS group fractured at the tightened distal screw region. The median fracture load for the A-PFN group was 132.1 N (97.1-173.69 N range), and for the A-DHS group it was 81.7 N (75.15-89.12 N range).

Conclusion:

A-PFN-treated unstable intertrochanteric fractured models resisted to higher levels of axial load than the A-DHS-treated group, with statistically significant difference. However, clinical studies are required to support these results. Level of Evidence V, Biomechanical study.

Keywords:
Femoral fracture; Fracture fixation; Intramedullary and plate