J Korean Fract Soc.  2003 Jan;16(1):29-36.

The proximal femoral nail for intertrochanteric fracture of the femur

Affiliations
  • 1Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea. kblee@hallym.or.kr
  • 2Department of Orthopedic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE: To evaluate the treatment results of geriatric intertrochanteric fractures using a proximal femoral nail.
MATERIALS AND METHODS
From April 2001 to Feburary 2002, 71 cases of the intertrochanteric fractures were treated with proximal femoral nail(PFN), more often in communited fractures involving lesser trochanter, transverse or reverse oblique intertrochanteric fracture. We evaluated the bone union time, neck-shaft angle, lag screw sliding by follow up radiographs, operation time, blood loss and complications.
RESULTS
The average age was 77.5 years old, the mean duration of follow-up was 9 months and the mean duration of bone union was 13.8 weeks. The average neck-shaft angle on immediate postop. x-ray was 131.9 +/-5.21 degrees and 129.9 +/-6.04 degrees at last follow up and the average lag screw sliding was 4.21 +/-4.13 mm. The average operation time was 61 minute and blood loss was 0.67 pints(134cc). Intraoperative complications were inadequate reduction in one case, difficulty in distal transfixing in one case and drill bit failure in one case and postoperative complications were loss of neck-shaft angle (more than 5 degree) in 12 cases, femur neck fracture in 2 cases and intraarticular cutting out of femur neck screw in one case.
CONCLUSIONS
The use of the proximal femoral nail could be appropriate for the fixation of communited or reverse oblique intertrochanteric fracture in elderly, osteoporotic patients for early ambulation, preventing shortening and rotation deformity, and reducing operation time and blood loss.

Keyword

intertrochanteric fracure; proximal femoral nail (PFN)
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