The Advantages of Using Titanium Trochanteric Fixation Nail System Instead of the Dynamic Hip Screw

Traditional short nail fixation devices used for intertrochanteric (IT) fractures of the femur have several surgeon and patient benefits. However, these devices have had a high incidence of complications. A new intramedullary device known as, Titanium Trochanteric Fixation Nail System (TFN), was designed to overcome these shortcomings has become commercially available. In comparing the two systems, it is seen that TFN has a better outcome with less complications than the traditional fixation, known as Dynamic Hip Screw (DHS).

A Dynamic Hip Screw (DHS), also referred to as sliding screw fixation, is a type of orthopaedic implant designed for the fixation of certain types of intertrochanteric and subtrochanteric fractures. It allows controlled dynamic sliding of the femoral head component along the construct. There are some complications that are involved with this procedure. The first is blood clots in the legs or lungs. This happens from dehydration, stress from the surgery, and prolonged immobilization. It is referred to as DVT, or P.E. Infection can also occur. This can happen any time there is a cut made on the skin. Antibiotics are usually prescribed to prevent this. Stress from a surgery can also cause cardiovascular stress as well as mini strokes, in some cases a full stroke. As a result of excessive blood loss a transfusion may need to be done. Occasionally a lag screw will start cutting out of the bone and move into the hip joint intra articular surface or near the skin surface. This depends on the operative technique and placement of the screw as well as bone quality.

Recently a new technique, Titanium Trochanteric Fixation Nail System (TFN), was developed to improve this procedure. Compared to the single lag screw, TFN improves resistance to control of the medical fracture, bringing superior life to cut out. This is because it permits an intramedullary, or inside of the bone, approach for fixation.

A few of the benefits of TFN compared to DHS are that TFN uses an 11 m helical blade that results in less bone removal than DHS. The removal of less bone allows for a smoother and simpler procedure. As well a quicker recovery times, because the less that is removed is the more the patient doesn't have to adapt to. The TFN system is versatile enough to be used for a number of fracture types in the femur and it offers a lateral entry point that is ideal for overweight patients. The versatility of the system will allow it to be used for a number of procedures rather than focusing on one, as the DHS did. This will cut the cost for doctors as they will be investing in a system that can qualify in numerous procedures. The lateral entry point is convenient as many patients needing this procedure are elderly and therefore less active, resulting in them being overweight. This entry point offers less mistakes with ease for surgeons. TFN offers a more superior life to the cut out when compared to DHS, and TFN's use of titanium alloy material improves on the mechanical and fatigue properties that were previously faced with DHS.

With the ability to improve on mobilization by using TFN as well as the fact of having to remove less bone and ease of entry, it is simple to say that TFN has vitally improved upon this procedure.

References
"Dynamic Hip Screw (DHS)." EDoctor, E Doctor, E-doctor, Online Doctor. Web. 17 May 2010.http://www.edoctor.co.in/#/dynamic-hip-screw/4529649829>.

"Synthes North America - Products." Welcome to Synthes North America. Web. 17 May 2010.http://us.synthes.com/Products/Trauma/Intramedullary+Nailing+Systems/Titanium+Trochanteric+Fixation+Nail+System+(TFN).htm>.