Lil NA, Makwana VR, Patel TD, Patel AR. Comparative study of intertrochanteric fracture fixation using proximal femoral nail with and without distal interlocking screws. World J Orthop 2022; 13(3): 267-277 [PMID: 35317250 DOI: 10.5312/wjo.v13.i3.267]
Corresponding Author of This Article
Nadeem A Lil, MS, Professor, Department of Orthopaedics, NHL Medical College, Ellis Bridge, Ahmedabad 380006, Gujarat, India. nadeemlil@yahoo.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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
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.
