Abstract
Objective. The aim of this study was to use three-dimensional (3D) computational modeling to compare the geometric fitness of these two kinds of proximal femoral intramedullary nails in the Chinese femurs. Computed tomography (CT) scans of a total of 120 normal adult Chinese cadaveric femurs were collected for analysis. With the three-dimensional (3D) computational technology, the anatomical fitness between the nail and bone was quantified according to the impingement incidence, maximum thicknesses and lengths by which the nail was protruding into the cortex in the virtual bone model, respectively, at the proximal, middle, and distal portions of the implant in the femur. The results showed that PFNA-II may fit better for the Chinese proximal femurs than InterTan, and the distal portion of InterTan may perform better than that of PFNA-II; the anatomic fitness of both nails for Chinese patients may not be very satisfactory. As a result, both implants need further modifications to meet the needs of the Chinese population.
Highlights
Intramedullary fixation device has advantages from the biomechanical point of view and has become increasingly popular in treating unstable trochanteric fractures [1, 2], but serious implant-related complications have been reported, such as femoral shaft fracture [3], cutting out [4], lateral migration of the femoral neck screw [4, 5], and distal locking [6, 7]
According to the Proximal Femoral Nail Antirotation (PFNA)-II morphological parameters provided by Synthes and the InterTan morphological parameters provided by Smith & Nephew, 3D models of the two implants were reconstructed with Pro E 4.0 (PTC, MA, USA) software
Intraoperative and postoperative complications associated with intramedullary nails in the treatment of intertrochanteric fracture can result from imperfect fitness of an internal implant with specific morphology of the human bone
Summary
Intramedullary fixation device has advantages from the biomechanical point of view and has become increasingly popular in treating unstable trochanteric fractures [1, 2], but serious implant-related complications have been reported, such as femoral shaft fracture [3], cutting out [4], lateral migration of the femoral neck screw [4, 5], and distal locking [6, 7]. Lots of intra- and postoperative complications were reported since it was used in Asians, such as pain around the hip and the thigh, femoral shaft fracture, lateral blade migration, and lateral cortex splitting during operation [9, 11, 12]. The flat lateral shape at the proximal portion of PFNA-II made it easier to be inserted intraoperatively, and its shortened proximal tip significantly reduced the postoperative hip pain [13, 14], but some Asian patients still complained about thigh pain after operation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
