Hip Pelvis.  2019 Mar;31(1):48-56. 10.5371/hp.2019.31.1.48.

Trochanteric Fixation Nail® with Helical Blade Compared with Femoral Neck Screw for Operative Treatment of Intertrochanteric Femoral Fractures

Affiliations
  • 1Department of Trauma Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands. j.vanleur@asz.nl
  • 2Department of Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands.

Abstract

PURPOSE
This study was performed to compare outcomes of the Trochanteric Fixation Nail (TFN®) with a helical blade versus TFN® with a femoral neck screw for the treatment of intertrochanteric femoral fractures.
MATERIALS AND METHODS
A single center, retrospective cohort study. Patients (>18 years of age) with an intertrochanteric femoral fracture, who were operated on between January 1, 2012 and December 31, 2016 were included. Primary and secondary outcome measures were cut-out rate and intervention variables, respectively. Data from X-ray examinations and patient medical files were collected and analyzed. The chi-square test or Student's t-test were used for statistical analysis.
RESULTS
A total of 631 patients were surgically treated for an intertrochanteric femoral fracture. Of this group, 239 patients (37.9%) were treated with a TFN® with helical blade and 392 patients (62.1%) with a TFN® with femoral neck screw. There were no statistically significant differences between the baseline characteristics of both groups. A total of 17 (2.7%) cut-outs were recorded, with no statistically significant difference between the two groups (P=0.19). Additionally, there were no statistically significant differences in the secondary outcome measures between the two groups.
CONCLUSION
There are no statistically significant differences in primary and secondary outcomes following treatment of intertrochanteric femur fracture with the TFN® helical blade or TFN® femoral neck screw. These findings suggest that the choice of collum implant for the surgical treatment of intertrochanteric femur fractures cannot be made based on the surgical outcomes of the two implants evaluated here.

Keyword

Hip fractures; Trochanteric fixation nail; Helical blade; Femoral neck screw; Cut-out

MeSH Terms

Cohort Studies
Femoral Fractures*
Femur Neck*
Femur*
Hip Fractures
Humans
Outcome Assessment (Health Care)
Retrospective Studies

Figure

  • Fig. 1 Flowchart inclusion/exclusion. TFN®: Trochanteric Fixation Nail (Synthes, Raynham, MA, USA).

  • Fig. 2 Cleveland index.

  • Fig. 3 Calculation of the tip-apex distance (TAD).AP: anteroposterior; Lat, lateral.

  • Fig. 4 Collum implant position according to the Cleveland index.


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