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TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA)
TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA)
The TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA) is designed to advance hip fracture treatment with an outcomes-based design, reduced procedural complexity, and comprehensive surgical options to meet previously unmet needs of surgeons, OR staff, and administrators.
It incorporates the best elements of our highly successful global hip nails (TFN, PFNA™*, and PFNA II™*), optimized through input from hundreds of surgeons around the world to deliver truly modern innovation in hip fracture treatment.
*Not cleared in the US.
Surgical Technique Guide
Surgical Technique Guide (Screw Only)
Instructions for Use
Features & Benefits
Improved Anatomical Fit Contoured Design
Improved nail shape (1.0m anatomic bow) based on multi-ethnic 3-D computational study designed to better fit patient anatomy1,2 and to help avoid impinging anterior cortex compared to nails with larger radius of curvature.
Small Proximal Diameter
Small proximal diameter (15.66mm) and LATERAL RELIEF CUT™ Design help to preserve bone in insertion area due to reduced critical width.
LATERAL RELIEF CUT™ Design
Design of the nail avoids impingement on lateral cortex.
TFNA Helical Blade
TFNA Helical Blade technology is designed to compress bone during insertion, which enhances implant anchorage and may reduce the risk of cut-out.
BUMP CUT™ Design
Titanium alloy and BUMP CUT Design of proximal hole provides improved fatigue strength compared to existing nails of similar size.5
Lies flush to Lateral Cortex
Oblique lateral end of both blade and screw lies flush to lateral cortex to reduce protrusion on soft tissue.
Static Locking Option
Static locking option holds blade or screw in a fixed position to help maintain femoral neck length.
Radiolucent insertion handle
Radiolucent insertion handle with radiographic indicators improves x-ray visualization and assists with guide wire placement.
QUICK CLICK™ Self-Retaining Technology
QUICK CLICK™ Self-Retaining Technology designed for easy attachment of nail to insertion handle.
Allows for sliding of blade or screw head element
Utilizes the Flexible Screwdriver
Provides a fixed construct with no head element movement
Utilizes Hex Screwdriver with TLA
Choice of Head Elements
Choice of both TFNA Helical Blade or TFNA Screw to suit a wide variety of clinical needs, which supports surgical preferences and helps facilitate hospital standardization.
Optional percutaneous set with large instruments including protection sleeve and insertion handle.
Distal Locking Options
Long nail provides three distal locking options, including a oblique distal hole that is offset an additional 10° to target bone in condyles.
Wide Selection of Nails
Wide selection of nail lengths and diameters covers broad array of patient anatomy.
Clinical and Biomechanical Evidence
- Schmutz, B., Amarathunga, J., Kmiec, S., Jr, Yarlagadda, P., & Schuetz, M. (2016). Quantification of cephalomedullary nail fit in the femur using 3D computer modelling: a comparison between 1.0 and 1.5m bow designs. Journal of orthopaedic surgery and research, 11(1), 53.
- Yuan, H., Acklin, Y., Varga, P. et al. A cadaveric biomechanical study comparing the ease of femoral nail insertion: 1.0‐ vs 1.5‐m bow designs. Arch Orthop Trauma Surg 137, 663– 671 (2017).
- Goffin JM, Pankaj P, Simpson AH, Seil R, Gerich TG. Does bone compaction around the helical blade of a Proximal femoral nail anti-rotation (PFNA) decrease the risk of cut-out? A subject-specific computational study. Bone Joint Res. 2013;2(5):79-83.
- Windolf M, Muths R, Braunstein V, Gueorguiev B, Hänni M, Schwieger K. Quantification of cancellous bone-compaction due to DHS Blade insertion and influence upon cut-out resistance. Clin Biomech (Bristol, Avon). 2009;24(1):53-8.
- DePuy Synthes Trauma. Gamma3 Construct Fatigue Technical Memo. 2014 Windchill # 0000122418
TFN-Advanced™ Proximal Femoral Nailing System is intended for treatment of fractures in adults and adolescents (12-21) in which the growth plates have fused. Specifically, the system is indicated for: stable and unstable pertrochanteric fractures; intertrochanteric fractures; basal neck fractures; combinations of pertrochanteric, intertrochanteric, and basal neck fractures.
The Long Nail is additionally intended for treatment of fractures in adults and adolescents (12-21) in which the growth plates have fused for the following indications: subtrochanteric fractures; pertrochanteric fractures associated with shaft fractures; pathologic fractures (including prophylactic use) in both trochanteric and diaphyseal regions; long subtrochanteric fractures; proximal or distal non-unions, malunions and revisions.
Both the short and long TFNA Systems are additionally indicated for use with cleared, polymethylmethacrylate (PMMA) bone cement that can be delivered through the fenestrated blade or screw via a cannula in skeletally mature adults with risk of cut-out or device instability due to poor bone quality.
Contraindications for TFNA System with PMMA bone cement:
When used with bone cement: Risk for intra-articular cement leakage; Acute traumatic fractures with good bone quality; Intracapsular hip fractures; In the presence of active or incompletely treated infection at the site where the bone cement is to be applied.
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