ArticleBMC musculoskeletal disorders2017
Influence of different great trochanteric entry points on the outcome of intertrochanteric fractures: a retrospective cohort study.
Article in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 19 citations in OpenAlex.
- Unravelling variations: an examination of entry point selection in proximal femoral cephalomedullary nailing.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Trial
- Lateral decubitus positioning was associated with improved efficiency and functional outcome compared with traction table positioning for cephalomedullary nailing of subtrochanteric femur fractures: a retrospective comparative study.BMC musculoskeletal disorders · 2026Article
- The positioning of cephalon medullary nailing correlated with hidden blood loss during the perioperative period in patients with intertrochanteric fractures: A retrospective study.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Anatomical structure of the medullary cavity of proximal femur with three-dimensional computed tomography.BMC musculoskeletal disorders · 2025Article
- The "foothill" entry for cephalomedullary nailing in unstable proximal femoral fractures: a technical note with a review of the literature.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Review
- Key factors for increased tip-apex distance when treating intertrochanteric fractures with InterTAN nails.Frontiers in bioengineering and biotechnology · 2024Article
- Optimal entry point for antegrade and retrograde femoral intramedullary nails.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2023Review
- Article
- Time to entry point and distal locking of intramedullary nails: a methodological phantom study comparing biplanar and uniplanar surgical imaging.BMC musculoskeletal disorders · 2022Article
- Iatrogenic gluteus medius muscle insertion injury while trochanteric entry nailing due to trochanteric fractures: a comparative study in forty patients with gray-scale ultrasound and shear-wave elastography.International orthopaedics · 2021Article
- Early Experience with the Trochanteric Fixation Nail-Advanced (TFN-A): A Descriptive Review of Thirty-Four Cases from a Single Center.Indian journal of orthopaedics · 2021Article
- [Comparison of proximal femoral nail anti-rotation operation in traction bed supine position and non-traction bed lateral position in treatment of intertrochanteric fracture of femur].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Proximal Femoral Nail Antirotation (PFNA) system for treatment of intertrochanteric fractures is currently widely applied worldwide. However, even though the PFNA has produced good clinical outcomes, a poor introduction technique with an inappropriate entry point can cause surgical complications. Some researchers suggest improving clinical outcomes by modifying the entry point, but no research has focused on this issue. The purpose of the present study is to compare the clinical and radiological outcomes of two different trochanteric entry points for the treatment of intertrochanteric fractures using the PFNA system.
methodsFrom May 2010 to October 2015, a total of 212 elderly patients with intertrochanteric fractures who were treated with the PFNA-II system were included into this retrospective cohort study. Group LA (98 patients) was treated using a lateral anterior trochanteric entry point, and group MP (114 patients) was treated using a medial posterior trochanteric entry point. All patients underwent follow-up assessments at 1, 3, 6, and 12 months after surgery. Radiographic evaluation was based on the impingement, tip-apex distance (TAD) and the position of the helical blade within the femoral head. Clinical evaluation was based on the surgical time, fluoroscopy time, blood loss, hospital stay, visual analogue scale (VAS), thigh pain, and Harris hip score.
resultsThe impingement was significantly reduced (P = 0.011) in group MP. The helical blade positions were significantly lower (P = 0.001) in group MP. The TADs in group LA (22.40 ± 4.43) and group MP (23.39 ± 3.60) were not significantly different (P = 0.075). The fluoroscopy time of group LA (53.26 ± 14.44) was shorter than that of group MP (63.29 ± 11.12, P = 0.000). Five iatrogenic lateral proximal fractures and 3 helical blade cutouts occurred in group LA, but none occurred in group MP. At 1 and 3 months postoperation, the Harris hip scores were significantly higher in group MP (P = 0.001 and P = 0.000, respectively), and the VAS scores were lower (P < 0.05).
conclusionsThe medial posterior trochanteric entry point achieved excellent nail and helical blade position, reduced surgical complications, and enabled early hip function recovery but required longer fluoroscopy time than the lateral anterior trochanteric entry point.
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