In orthopedic surgery, precision and skill are essential when treating problems with the proximal femur. One of the most important instruments when fixing proximal femur fractures is the Proximal Femoral Nail Antirotation (PFNA) set.
What is the PFNA Instrument Set
The Proximal Femoral Nail Antirotation (PFNA) instrument set is a particular group of medical instruments used to fix broken proximal femur bones in orthopedic surgery. The purpose of it is to keep the fractured femur stable and let the patient move around quickly. Standard PFNA tool sets come with nails, screws, and guides made to work with the proximal femur.
Antirotation design is what makes the PFNA system unique. It helps keep the femoral head and neck from rotating relative to the femur shaft. This is important for fractures because they must be stable in all directions to heal correctly.
Anatomy of the Proximal Femur
In order to plan and carry out surgery, especially on operations like fixing hip fractures with the PFNA instrument set, it is important to understand how the proximal femur works.
The upper part of the thigh bone, or proximal femur, is a key part of hip surgery because it breaks easily, especially in older people. Understanding its structure is very important for surgery to go well. Here is a quick summary:
- A femoral head is the round top of the thigh bone that goes into the hip socket (acetabulum) to make the hip joint. It has joint cartilage covering it so that it can move easily.
- The femoral neck is a short, thin piece of bone that joins the femoral head to the femur’s shaft. Most breaks happen there, especially in older people.
- The greater trochanter is a bone bump on the proximal femur’s side. Several muscles connect to it, such as the medius and minimus gluteus.
- The lesser trochanter is a bony bump inside the proximal femur. The iliopsoas muscle attaches to it.
- The intertrochanteric line and crest are the line and ridge that run along the front of the thighbone between the greater and lesser trochanters. Muscles and ligaments bind to them.
- The femur is located just below the lesser trochanter within the subtrochanteric region. Because of the strong muscles and forces that act on this area, it can be hard to treat fractures there.
- The bone marrow is located in the middle hollow of the femur. You can put intramedullary nails or screws into this tube to make it more stable during surgery.
- A femoral neck angle is between the femoral shaft and the neck. This position is important for supporting weight and can change how the hip joint works.
- The medial and lateral circumflex femoral arteries bring blood to the proximal thigh. Isolation of this blood flow can cause avascular necrosis of the femoral head.
Understanding the PFNA Instrument Set
An orthopedic instrument set includes many things made from high-quality materials like carbon fiber, aluminum, and stainless steel.
These tools aim to do different things and meet multiple objectives during an operation or surgery. We at Uteshiya are doing everything we can to ensure that all of our medical tools meet the same high standards of quality.
So doctors have almost everything they need for surgery; there are a lot of different tools in the PFNA tools set. It is possible to change instruments to meet the needs of the customer. You can use all of these tools more than once.
Here is a list of what comes with the PFNA Instrument set.
- PFNA Distal Zig
- Cortex Reamer
- Ram RodDepth Gauge
- Nail Extractor
- PFNA Proximal Zig PFNA Zig Handle
- Driving Head
- Conical Bolt (Nail Holding Bolt)
- Proximal Sleeve Threaded With Nut
- Wire Sleeve
- Protection Sleeve
- Drill SleeveTrocar
- Medulary Tube
- PFNA Blade Extractor
- Solid Hammer
- Conical Bolt (Nail Holding Bolt) Tightner Slotted Hammer
- PFNA Blade Introducer
- PFNA Blade Reamer
Surgical technique step-by-step
Here are some important steps that must be taken to use the PFNA tool set in surgery. People usually go under spinal or general anesthesia for this operation, and they lie on their back on the operating table.
Step: 1
The surgery spot is cleaned up and covered with a clean cloth. By looking at the fracture through fluoroscopy, the doctor can figure out where to put the PFNA nail.
Step: 2
A cut is made over the side of the proximal femur to get to the broken part. The cut’s length may differ for each patient based on the type of fracture and their size.
Step: 3
The broken pieces are carefully placed (reduced) to return the femur to its normal shape and position. This could mean moving the limb and using special tools, depending on the situation.
Step: 4
Insert the guide wire into the femoral neck and head while using a fluoroscope to help. The guide wire’s position is highly significant because it shows where to put the PFNA nail.
The medullary tube of the femur is reamed so that it is ready for the nail to be put in. Reaming helps make sure that the nail fits and lines up correctly.
Step: 5
Put the PFNA nail in the femoral canal over the guide wire and move it into the femoral head. Carefully placed in the femoral head, the spiral blade at the end of the nail keeps it from rotating.
Step: 6
Fixing screws are put through the nail to keep it in place. These screws hold the nail in place on the bone, stopping it from moving and making it more stable.
Step: 7
The cut is stitched up in stages, and a clean bandage is on top.
Planning for the PFNA Instruments Set
To make an operation plan, the doctor must first carefully examine the patient and take X-rays to clearly show the patient’s bones and any abnormalities that may be present. The right insertion tools and a full set of PFNA instruments must be provided during the surgery.
The healthcare professional should talk to the patient about the risks and problems of implants. Before surgery, it’s important to determine if the patient is allergic to any implant materials. The patient should also be told that the promise of the device’s performance is not possible because problems can happen that shorten its useful life.
Postoperative Care and Rehabilitation
For a full recovery, it is very important to get postoperative care and therapy after surgery with the PFNA tool set. For most people, managing their pain with a variety of medicines is key.
Early movement with the help of a physical therapist can help keep problems from happening and speed up the fixing process.
Gradually moving up to a weight-bearing position depends on how stable the fracture is. Physical therapy aims to improve mobility, strength, and range of motion.
Start with using assistive aids. Following-up visits help check on health and change the treatment plan as needed. Aside from nutrition, eyeing for problems is also important in care. Patients and family members need to know about surgical care and therapy, so everyone can get better and return to their normal lives.
Precautions from PFNA Instrument set.
- As part of the cleaning process, ensure the PFNA Instruments Set works and look for signs of wear. Before using, replace any tools that are worn out or broken.
- It is suggested that you use the PFNA Set that has been labeled for your specific devices.
- Carefully handle the tools and put used bone-cutting tools in a Sharps Bin when you’re done with them.
- Always use irrigation and pressure to eliminate any debris created during insertion or removal.
PFNA Instrument set Warning.
- Not many instruments in this set will break when they are being used (when they are put under too much force). The surgeon must decide if the broken part should be removed based on the risk involved, but we suggest that it be removed whenever possible and makes sense for the patient. Keep in mind that implants aren’t as strong as natural bone. Things that put a lot of pressure on implants may cause them to fail.
- The PFNA Instrument Set might have rough edges or parts that move and can cut or tear the user’s glove or skin.
- Pay attention to removing any pieces that won’t stay in place during the surgery.
- The operator is the only one who can decide if an implant should be removed, but we suggest that fixing devices be taken out whenever possible and reasonable for the patient. This way, the devices cannot continue to help the patient heal. After removing an implant, the patient should be given the right care to keep the bone from breaking again.
Wrapping It Up
Risks, side effects, and bad things can happen with any extensive surgery. Infection, thrombosis, embolism, nerve and/or tooth root damage or injury to other critical structures, including blood vessels, excessive bleeding, damage to soft tissues including swelling and abnormal scar formation, functional impairment of the musculoskeletal system, and pain are some of the reactions that can happen.
