ArticleArchives of orthopaedic and trauma surgery2023
Retrospective evaluation of radiological and clinical outcomes after surgical treatment of proximal femur fractures utilizing TFNA.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed.
- [Trochanteric fixation nail advanced for trochanteric femoral fractures : Central cut-out as a new problem?]Unfallchirurgie (Heidelberg, Germany) · 2026Article
- Retrospective study of mechanical complications after cephalomedullary nail implantation from 2019 to 2024 following per-, sub- or intertrochanteric femur fractures.Archives of orthopaedic and trauma surgery · 2026Article
- Evaluating polymethylmethacrylate (PMMA) augmentation in cephalomedullary nail fixation of hip fractures: a step towards evidence-based patient selection criteria.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Article
- 3-year revision rates of left vs right cephalomedullary nails with a helical blade design.Irish journal of medical science · 2025Article
- Lower cortical thickness index does not correlate with increased surgical complications in proximal femoral fractures: a clinical and radiological study.Scientific reports · 2025Article
- Article
- Reduction quality in lateral view of X-ray and hypoalbuminemia are associated with postoperative mortality in elderly pertrochanteric fracture patients.Quantitative imaging in medicine and surgery · 2023Article
- Reduction Quality Determines Failure Behavior in Stable Intertrochanteric Fractures: A Mesh-Free Simulation Comparing DHS and TFNA.JB & JS open accessArticle
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6 authors.
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Abstract
introductionThe aim of this study was to evaluate the clinical and radiological outcomes of patients treated with the TFN-Advanced™ Proximal Femoral Nailing system (TFNA¸ DePuy Synthes, West Chester, PA) including intra- and postoperative complications. MATERIALS AND
methodsAll patients with an acute proximal femur fracture consequently treated with a TFNA between September 2014 and December 2018 were evaluated. Clinical and radiological data were assessed for intra- and postoperative complications, including treatment failure. In addition, intra- and postoperative X-rays were used to determine the position of the implant, and any migration, via tip-apex-distance (TAD) and the caput-collum-diaphyseal angle (CCD). The accuracy of the fracture reduction was rated by both observers according to Baumgartners criteria.
results275 consecutive patients (mean age 77.5 ± 14.1; 70.2% female) were included. The predominant OTA/AO fracture classification was 31A2 (140 cases, 50.7%). The average surgical time was 69 min (± 39.8). The reduction quality was good in 253 cases (92.0%) and acceptable in 22 cases (8.0%). In 18 cases, a pre-defined primary outcome parameter (6.5%) was recorded after a mean of 8.2 ± 8.0 months. During the observational period, 19 patients (6.9%) required a total of 23 additional surgeries. Implant removal was not considered a failure in the absence of pain. Significant group differences were observed with younger age (p = 0.001), lower Charlson Comorbidity Index (CCI)-score (p = 0.041) and lower rate of osteoporosis (p = 0.015) in the failure group. There were no cases of cut-out or cut-through among the patients who underwent augmentation as part of osteosynthesis.
conclusionsProximal femur fractures treated with the TFNA show low complication rates and high levels of radiological healing. Implant-related complications might be more common in patients with younger age, a lower CCI-score and lower frequency of osteoporosis. Usage of cement augmentation could potentially be beneficial to reduce postoperative cut-through and cut-out.
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