J Korean Fract Soc.  2007 Jan;20(1):40-44. 10.12671/jkfs.2007.20.1.40.

Treatment of Intertrochanteric Fracture with Proximal Femoral Nail

Affiliations
  • 1Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Korea. paedic@chol.com

Abstract

PURPOSE
To evaluate the efficacy of proximal femoral nail for intertrochanteric fracture.
MATERIALS AND METHODS
From June 2001 to March 2005, 45 intertrochanteric fractures were treated with a proximal femoral nail for intertrochanteric fracture and followed-up at least one year. The average age was 71.3 years (34~91 years). The causes of fracture were slip down in 38 cases and fall down in 7 cases. Fractures were classified with AO classification; 20 cases in type A1, 22 cases in type A2 and 3 cases in type A3. Antirotational pin was used in 25 of 45 fractures according to fracture stability. Radiological result was determined with a union. Walking ability was evaluated in the last follow-up.
RESULTS
The fractures were fixed in anatomical position in 36 cases, in valgus position in 3 cases and varus position in 6 cases. Union was occurred in 43 of 45 cases. The sliding distance of lag screw was an average of 5.63 mm and it had no association with fracture type, TAD, usage of antirational screw, usage of distal screw and BMD. Twenty-six of 45 patients (57.7%) were recovered to pre-injury state of walking ability. Complications were occurred in 3 patients (6%).
CONCLUSION
Proximal femoral nail was a useful instrument for all type intertrochanteric fractures, but antirotational pin was not necessary in the stable type A1 intertrochnatirc fractures.

Keyword

Femur; Intertrochanteric fracture; Proximal femoral nail

MeSH Terms

Classification
Femur
Follow-Up Studies
Hip Fractures
Humans
Walking

Figure

  • Fig. 1 Photograph shows a measurement of neck diameter and a diameter that was made by two pin. A indicate femoral neck diameter. B indicates sum of diameter of two screws and their interspace.

  • Fig. 2 A 69 year old female who underwent internal fixation with a proximal femoral nail for intertrochanteric fracture. Radiograph shows no more space to insert an antirotational pin after fixation of lag screw.

  • Fig. 3 This diagram shows the distribution of femoral neck diameter of neck diameter of 44 patients.

  • Fig. 4 (A) A 72 year old man had a nonunion with metal failure 7 months after internal fixation with proximal femoral nail for intertrochanteric fracture. (B) The nail breakage occurred through the hole for lag screw.


Cited by  1 articles

Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu
J Korean Orthop Assoc. 2011;46(5):399-404.    doi: 10.4055/jkoa.2011.46.5.399.


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