![]() insertion of the antirotation pin/screw.drilling of the holes for antirotation pin/screw and lag screw.opening of the insertion point at the top of the greater trochanter.exact anatomic closed reduction on the traction table.The surgical technique comprises several steps including the following 1:ĭetermination of nail length, diameter as well as angle and anteversion of lag screw insertion ContraindicationsĬontraindications of proximal femoral nail fixation are medial femoral neck fractures. Other indications include pathological fractures and extended subtrochanteric fractures especially in cases utilizing the long version. The main indications of the proximal femoral nail are the treatment of peritrochanteric, intertrochanteric and subtrochanteric fractures with the fracture type AO/OTA 31-A1 31-A2 and 31-A3 1. The proximal femoral nail was introduced for the treatment of proximal femoral fractures in 1997 1. It can be combined with a wire cerclage with an open reduction for additional stability in complicated subtrochanteric fractures 2. The proximal femoral nail comes also in different lengths with a version reaching caudally up to the distal femoral metaphysis. Longer nails are designed to treat low and extended subtrochanteric or combined trochanteric and femoral shaft fractures. There are different versions for different CCD angles available. There are small holes at the distal end of the nail for locking screws 1. But different to the gamma nail, the proximal femoral nail features two proximal openings, a larger one further distally for a large femoral neck lag screw and a smaller one immediately above for a smaller anti-rotation screw/pin. Similar to the gamma nail the proximal femoral nail consists of a funnel-shaped intramedullary nail with slight bending to reflect proximal femoral diaphyseal trochanteric morphology. The proximal femoral nail (PFN) is an osteosynthetic implant designed to treat proximal femoral fractures in the trochanter area with a closed intramedullary fixation method. ![]()
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