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Augmented versus non-augmented Trochanteric Fixation Nail-Advanced (TFNA) nails for treating trochanteric fractures in patients over sixty-five years of age

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A Letter to the Editor to this article was published on 13 March 2024

Abstract

Purpose

Intramedullary nailing is a common treatment for pertrochanteric fractures. However, implant-related mechanical failures, such as cut-out and cut-through, lead to higher rates of revision surgery, loss of autonomy, and mortality. Cemented augmentation enhances the bone-implant interface. This study compared the frequency of mechanical failures between augmented and non-augmented Trochanteric Fixation Nail-Advanced (TFNA) nails.

Methods

This descriptive, retrospective study at a level 1 trauma centre included patients aged > 65 years with pertrochanteric fractures treated by a short augmented or non-augmented TFNA nail. The primary outcome was the comparison of cut-out or cut-through rates between groups at three and six months postoperatively.

Results

Of the 181 patients analysed, 103 had augmented TFNA nails and 78 had non-augmented TFNA nails. There were no statistically significant differences between groups in terms of demographic characteristics, AO/OTA classification, or quality of reduction. The failure rate was significantly lower in the augmented group than in the non-augmented group: 1 (0.97%) versus 9 (11.54%) (p = 0.005). At six months postoperatively, there was no significant difference between the two groups concerning functional recovery, as measured by the Parker and EuroQoL 5-Dimensions scores.

Conclusions

For patients aged over 65 years, the use of the augmented TFNA nail may reduce the risk of fixation failures such as cut-out.

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Data availability

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Authors and Affiliations

  1. Service d’Orthopédie Et de Traumatologie, CHRU Brest Cavale Blanche, Boulevard Tanguy Prigent, 29200, Brest, France

    Marie Fernandez, Yoann David, Frédéric Dubrana, Hoel Letissier & Rémi Di Francia

  2. Service d’Orthopédie Et de Traumatologie, CHU Grenoble Alpes – Hôpital Sud, Avenue de Kimberley, 38130, Echirolles, France

    Valentin Merle Du Bourg

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  1. Marie Fernandez
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MF and YD. The first draft of the manuscript was written by MF, and all authors commented on previous versions of the manuscript. Statistical analyses were performed by VMDB and HL. All authors read and approved the final manuscript.

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Correspondence to Rémi Di Francia.

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The authors declare no competing interests.

Ethics approval

The study was approved by the local ethics committee (B2023CE.11). Reference 29BRC23.0035.

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Informed consent to participate in the study has been obtained from participants.

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This study was conducted at the Brest University Hospital, Centre Hospitalier Régional Universitaire de Brest, Boulevard Tanguy Prigent, 29200 Brest, France.

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Fernandez, M., Du Bourg, V.M., David, Y. et al. Augmented versus non-augmented Trochanteric Fixation Nail-Advanced (TFNA) nails for treating trochanteric fractures in patients over sixty-five years of age. International Orthopaedics (SICOT) 48, 831–840 (2024). https://doi.org/10.1007/s00264-023-06073-5

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