DePuy Synthes Targets Better Hip Fracture Outcomes with New Nailing System

J&J’s DePuy Synthes has chosen this year’s AAOS congress at which to launch its TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA), a nail, blade and screw system designed to improve patient outcomes by more closely matching the anatomy of patients undergoing hip fracture surgery.


In a newly issued press release, DePuy Synthes points to the fact that each year, more than 1.6 million people across the world sustain a hip fracture, with estimates that 6.3 percent of patients undergoing surgical treatment require revision surgery following failure of the original nail implant. The company says its TFNA System helps address this issue by offering a nail designed to better fit the patient anatomy.

The solution apparently lies in a combination of enhanced bone preservation and improved anatomical conformity. The LATERAL RELIEF CUT™ Design of the TFNA Nail and small diameter at the top of the nail help preserve bone and aid in ensuring a proper fit where the nail is inserted during surgery.

Based on an extensive multi-ethnic 3D computational study of femoral anatomy the TFNA Nail is curved, thereby enhancing its overall anatomical shape, a feature which can help avoid impingement lower in the leg on the anterior cortex.

The TFNA System is made from a unique titanium alloy and incorporates what DePuy Synthes calls a BUMP CUT™ Design that make the nail stronger than existing hip fracture nails of similar size. It points to data suggesting less breakage than other commercially available nails in testing.

The Helical Blade helps the nail hold the head of the femur secure and allow proper healing. This design, proprietary to DePuy Synthes Companies, compresses bone around the implant during insertion, which may result in a more secure implant and fewer failures resulting from “cut out” of the device. This is one of the most frequent complications associated with hip fracture nailing and often results in re-admission for revision second surgery to fix the failure.

Finally, the TFNA System features new instrumentation designed to reduce procedural complexity and offers a comprehensive range of surgical options. The fully radiolucent insertion handle provides improved x-ray visualization and features QUICK CLICK™ Self-Retaining Technology, designed for easier attachment of the nail to the instruments. The new system also offers surgeons an extensive range of nail sizes and the choice of both a blade and screw options to suit a wide variety of clinical needs and to facilitate hospital standardization, which may help reduce costs.

Physician comments

“A big concern, especially in elderly patients with hip fractures, is matching patient anatomy to help avoid complications such as anterior cortical impingement, and the radius of curvature of the TFNA Nail may help reduce that risk,” said Christopher Finkemeier, MD, Co-Director of the Acute Care Orthopaedic Service at Sutter Roseville Medical Center and member of the AO TK Intramedullary Nailing Expert Group. “Having one system with both a screw and blade and simplified instrumentation are important for the surgeon as well. This system may help improve outcomes and minimize complications, with less time and cost in the OR.”

Company comments

“We saw an important clinical need and wanted to address it in a significant way,” said I.V. Hall, Franchise Unit Leader, DePuy Synthes Trauma. “We looked at every aspect of nail design and instrumentation, and considered input from hundreds of surgeons, hospitals and academic institutions worldwide. We then took all this data, our vast experience in designing some of the world’s leading trauma systems and developed the TFNA System, which has the potential to improve patient outcomes, improve efficiency in the operating room, help reduce costs and increase patient satisfaction.”

 Source: DePuy Synthes Companies

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