Langenbeck's archives of surgery · 2004
Pitfalls and complications in the use of the proximal femoral nail.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Windolf Joachim, Hollander Dirk A, Hakimi Mohssen, Linhart Wolfgang
Аннотация
BACKGROUND AND AIMS: Osteosynthesis with the proximal femoral nail (PFN) features the advantages of high rotational stability of the head-neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. However, the use of the nail is technically ambitious and is accompanied by some risks of error, which can lead to failure of the osteosynthesis. In this paper we present the results of a critical analysis of mistakes that were made in our hospital during the introduction period of this implant.
PATIENTS AND METHODS: We carried out a prospective analysis of the data of 121 consecutive patients who were suffering from trochanteric or subtrochanteric fracture between December 1997 and December 2000 and who had been treated with a PFN.
RESULTS: We identified intraoperative technical difficulties in 23 patients (19.1%). Seven cases showed postoperative local complications that required operative revision on six patients (4.9%). The main reasons for the failure of the operations involved were poor reduction and wrong choice of screws. Following our critical analysis, we were able to avoid those problems.
CONCLUSIONS: When 31A fractures are to be stabilised with a PFN, the precise technical performance of the implantation represents the basic surgical requirement. Already present minor deviations will subsequently cause loosening of the implants and failure of the operation.
PATIENTS AND METHODS: We carried out a prospective analysis of the data of 121 consecutive patients who were suffering from trochanteric or subtrochanteric fracture between December 1997 and December 2000 and who had been treated with a PFN.
RESULTS: We identified intraoperative technical difficulties in 23 patients (19.1%). Seven cases showed postoperative local complications that required operative revision on six patients (4.9%). The main reasons for the failure of the operations involved were poor reduction and wrong choice of screws. Following our critical analysis, we were able to avoid those problems.
CONCLUSIONS: When 31A fractures are to be stabilised with a PFN, the precise technical performance of the implantation represents the basic surgical requirement. Already present minor deviations will subsequently cause loosening of the implants and failure of the operation.