Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May 10;11(2):103-9.
doi: 10.1016/j.jor.2014.04.004. eCollection 2014 Jun.

Favorable radiographic outcomes using the expandable proximal femoral nail in the treatment of hip fractures - A randomized controlled trial

Ofir Chechik  1 , Eyal Amar  1 , Morsi Khashan  1 , Tamir Pritsch  1 , Michael Drexler  1 , Yariv Goldstein  1 , Ely L Steinberg  1
Affiliations

Favorable radiographic outcomes using the expandable proximal femoral nail in the treatment of hip fractures - A randomized controlled trial

Ofir Chechik et al. J Orthop. .

Abstract

Aim: To compare the functional and radiographic results of dynamic hip screw (DHS) and expandable proximal femoral nail (EPFN) in the treatment of extracapsular hip fractures.

Methods: A randomized controlled trial of sixty hip fracture patients. Outcomes included mortality, residency, independence, mobility, function and radiographic results at a minimum of 1 year.

Results: Twenty-nine EPFN patients demonstrated fewer cases of shaft medialization or femoral offset shortening compared to the 31 DHS patients. Mortality, complications and functional outcomes were similar.

Conclusion: EPFN provides stable fixation of pertrochanteric hip fractures and prevents neck shortening that is commonly observed after DHS fixation.

Keywords: Dynamic hip screw; Expandable; Hip fracture; Offset; Proximal femoral nail.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Expendable proximal femoral nail system.
Fig. 2
Fig. 2
Lateral X-ray view of femur following insertion of EPFN demonstrating longitudinal crack (arrow).
Fig. 3
Fig. 3
AP X-ray views of left proximal femur demonstrating (a) an unstable (31A2) intertrochanteric fracture treated with (b) an EPFN and maintaining postoperative (c) reduction at union.
Fig. 4
Fig. 4
AP X-ray views of left proximal Femur demonstrating (a) an unstable (31A2) intertrochanteric fracture treated with (b) a DHS, restoring proximal femur anatomy, but with (c) shortening of femoral neck and reduced femoral offset at union.
See this image and copyright information in PMC

References

    1. Lenich A., Vester H., Nerlich M. Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip-blade vs screw. Injury. 2010 Dec;41:1292–1296. - PubMed
    1. Saudan M., Lübbeke A., Sadowski C. Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma. 2002 Jul;16:386–393. - PubMed
    1. Pajarinen J., Lindahl J., Michelsson O. Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation. J Bone Joint Surg Br. 2005 Jan;87:76–81. - PubMed
    1. Zou J., Xu Y., Yang H. A comparison of proximal femoral nail antirotation and dynamic hip screw devices in trochanteric fractures. J Int Med Res. 2009 Jul-Aug;37:1057–1064. - PubMed
    1. Barton T.M., Gleeson R., Topliss C. A comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur: a prospective randomized trial. J Bone Joint Surg Am. 2010 Apr;92:792–798. - PubMed